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Re: [IP] Medicare questions
"...This is the way it works for me. I use National Diabetic Pharmacies. I
my supplies they ship, bill Medicare which pays 80% and my insurance co
pays 20% I pay nothing. Some of this depends on your instance. This
my strips and pump supplies....."
For those who have Medicare as primary insurance (and may not have used it
before for pump supplies), please be aware that Medicare only covers one (1)
infusion set per week, yet no limit on reservoirs-go figure, though
sometimes a bill for more than 1/wk will slip through. However, using the
appeals process with appropriate documentation usually results in a hearing
officer finding in "your" favor.
Hubby also uses National Diabetic Pharmacies (his secondary requires this
for the rest of any costs to be paid by it), and NDP has been great-they
start the appeals process, do all the work, and Hubby just gets the letters
throughout the long time the appeals process takes. He just got one last
week stating that the cost of the "extra" infusion sets he got in 9/01 would
be paid by Medicare. Also, batteries (even if called "power packs") are not
covered, as well as some other necessary stuff, but a good secondary
insurance usually picks up the cost of these.
Oh, Jim, how about that 31 day log of glucose monitoring results that
Medicare requires to "prove" your testing frequency? Hubby gave up 'cause
the NDP one has such small spaces so I do one for him using Word that he can
just sign. We find all the reps @ NDP great-and the pump dept has such good
folks, head of dept can be reached 24 hrs/day. Hubby's insurance required
him to use NDP to get his pump though the CDE @ his endo's office was
"approved" to do, and did, his training.
>From day 1 years ago when Hubby's insurance started requiring NDP be used to
get syringes, alcohol swabs, test strips, etc, NDP has been great. Also
great is that his secondary picks up any costs for diabetic supplies not
covered by Medicare. He counts his blessings every day on that score.
Marj of Marj; Mike (I'm not into computers, but glad to be on this list);
and "Ace, the PP" (portable pancreas)
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