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RE: [IP] Re: Medicare (of course)



Hi Pam, 

You've always been such a great help to all of us!  Thank you.

I did get my first pump prior to going on Medicare, but the years have
passed and now I'm stuck with Medicare's rules.  One good thing actually
happened  today, however.  My MM Rep had been trying to get me a 700-series
pump, since it holds more insulin than my little 523, but Medicare wouldn't
allow it since I have 7 more months on my warranty.  Well, lately it's been
giving me a lot of motor errors and no delivery errors.  When I couldn't
clear them today, I called up MM, and after what I considered a total waste
of time trouble-shooting, it was decided I should have a replacement pump.
The GOOD part is that they no longer have any 500-series pumps, so they're
going to replace it with a 700 series!  I find that totally ironic, since
they refused me that pump and now they have no choice.  Anyway, come
December, I'm still going to the Tandem T:Slim.  I WIN!  Never thought it
would happen.

Sue
"One of the greatest experiences in life is making a difference in someone
else's life." 


-----Original Message-----
From: email @ redacted
<email @ redacted> On Behalf Of Pam Brown
Sent: Saturday, April 14, 2018 1:27 PM
To: email @ redacted
Subject: [IP] Re: Medicare (of course)

<< Sorry you're having trouble Sue, but yes, MM should give you whatever
quantity of supplies the doctor writes on the prescription so that's what
you need to check first. That all is dictated by Medicare rules, not
Medtronic. They can't deviate from that and bill Medicare for it because
they're bound by Medicare rules as Medicare is the payer. They're subject to
audits and losing their Medicare supplier status if they don't follow the
rules. This would be true with whoever supplies your reservoirs.

 Also, the 5 year pump rule for Medicare applies to all pumps, not just
Medtronic. I know it's very frustrating, but the idea behind it is to save
taxpayers money from replacing equipment that's working fine. CMS must have
analyzed the data and decided that even though pump warranties are for 4
years the majority actually last 5 years. So anyone who wants a new pump
should find a way to get it before starting Medicare. Pam>>
.
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