Medicare started a national mail-order program for diabetes supplies on July 1, 2013. The program contracts with specific suppliers, which were selected based on a competitive bidding process.
If you have Original Medicare, you may need to get your home-delivered test strips from a contracted supplier in order for Medicare to cover them. Contracted suppliers must accept Medicare’s approved amount as payment in full for diabetes supplies. They can charge you only the 20% coinsurance, once you meet your deductible. The amount Medicare will pay suppliers for test strips will be lower starting on July 1. That means that the coinsurance amount you pay will likely be less as well.
The mail-order program is in effect in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam and American Samoa. It applies only to people who have Original Medicare. If you have a Medicare Advantage plan, contact your plan for more information.
Do You Need to Switch Suppliers?
It’s important to find out whether your current mail-order supplier is a Medicare contract supplier. If it is, then that’s great. You can just keep on as usual. If your mail-order supplier is not contracted with Medicare, then Medicare will not cover what you buy. You need to find a contracted mail-order supplier that sells the strips you use.
To change suppliers, you can usually just transfer your existing prescription to the new supplier. In some cases, you may need a new prescription.
You can visit Medicare’s online Supplier Directory to see if your current supplier is contracted. Just enter your zip code. If you don’t see your supplier there, you can look for another one to use.
If You Buy Diabetes Supplies Locally
Some pharmacies and stores stock and sell diabetes test strips and other supplies. Beginning July 1, 2013, Medicare will pay the same amount for supplies, whether you buy them at a store or have them delivered to your home. You will pay a 20% coinsurance after your deductible is met.
Local stores may charge you more than what Medicare will cover if they do not accept what Medicare pays as payment in full. (Contracted mail-order suppliers may not charge more than Medicare will cover.) Be sure to ask the store or pharmacy you use how much you will be charged for diabetes testing supplies. If it is more than a 20% coinsurance, you may want to look for another place to buy supplies.
For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. - 8 p.m. local time, seven days a week.
Resources
Message to Beneficiaries: Read the letter Medicare sent to beneficiaries about the program.
Medicare Supplier Directory: Find a Medicare contracted supplier—just enter your Zip code.
Medicare.gov: Visit the official U.S. government site for Medicare.
Y0066_130702_105914 CMS Accepted
http://blog.medicaremadeclear.com/blog/bid/116979/Medicare-Starts-Mail-Order-Program-for-Diabetes-Supplies?WT.mc_id=880580
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