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Reader Alert: New Medicare Rules take Effect July 1st for Mail Order Diabetic Supplies and Various Medical Equipment such as Oxygen. Please read below:
Dear Toni:
I am diabetic and need help!! I order my diabetic test strips from a mail-order program and are delivered to my front door. Toni, I received a letter stating my supplier will no longer be covered by Medicare because it is not a “competitive bidding” supplier. Does this mean that if I continue with my current supplier, Medicare will stop paying for my diabetic test strips? What is going on? Sandra from Memorial area
Hello Sandra:
Beginning on Monday, July 1, 2013, Medicare started new rules about mail-order diabetic supplies, such as test strips and lancets. And this is confusing a lot of folks!!
If Medicare is your primary insurance, you use only “Original” Medicare Parts A and B (this does not affect a Part C Medicare Advantage plan) and you order your supplies from a mail-order supplier, you must use suppliers who have been awarded a contract under a new “competitive bidding” rules or you will have to pay 100% out of your pocket. Confusing, I know.
Medicare has a listing of these approved suppliers; the list is available either online at www.medicare.gov or by calling 1-800-Medicare.
The new mail-order program does not require you to change the particular testing monitor, test strips and lancets you currently are using. Remember, Medicare only wants you to use the mail-order supplier that they approve. If you are happy with the monitor, test strips and lancets you are currently using, you will want to use a competitive bidding supplier that stocks your testing items. You will need to provide your new supplier with either a new prescription for your diabetic supplies or have your current prescription transferred. Talk to your doctor about a new prescription.
If you would rather, you could opt to discontinue home delivery of your diabetic supplies and purchase your diabetic supplies at a local pharmacy (that is enrolled in Medicare). This way, “Original Medicare” Part B will provide the diabetic supplies and you have to pay the 20% co pay or your Medicare Supplement or retirement insurance can pick up the 20%. If you have more questions about the changes in Medicare’s policy, contact Medicare at 1-800-Medicare or talk to your pharmacy. I am sure the pharmacies are being bombarded with questions.
Here is another Medicare change which began July 1st …concerning Durable Medical Equipment sent to your house, such as wheel chairs, walkers, oxygen, CPAC devices, at home wound equipment or any type of medical device you use at home.
Medicare will only cover a Durable Medical Equipment or at-home supplier in your area that have either a competitive bidding status or has been “grandfathered”. What is “grandfathered”? A “grandfathered” supplier simply means Medicare will continue to cover the supplier’s current customers for a “limited” period of time.
If your supplier has been granted a “grandfathered” status, you may continue to use this medical supplier after July 1, 2013. BUT!! At some time in the future, you will need to switch to a competitive bidder of medical equipment.
Remember to confirm with your “grandfathered” medical supplier, the time length you may continue to use that particular supplier under Medicare’s new rules.
Once the “grandfathered” time limit has expired, you will need to use a competitive bidding medical supplier or you may have to pay 100% out of your pocket.
Toni Says: Be sure you are using a competitive bidding medical supplier when receiving your medical equipment at home or you might have to pay 100% out of your pocket!!
Toni King, Medicare advocate, consultant and author of Medicare Survival Guide and the new Confused about Medicare workshop DVD(video) available only at www.tonisays.com. Sign up for the new Medicare Survival newsletter available at www.tonisays.com. For any Medicare questions, contact Toni at www. Tonisays.com/ask-toni…
