Does Medicare pay for diabetes treatment? How about diabetic supplies? Will my Medicare plan pay for insulin? How can I save money on my diabetic prescription drugs?
If you have diabetes, you need a good Medicare plan that will cover most of your out of pocket costs for care and allows you the freedom to choose your own doctor. Once you find a doctor that can help you regulate your sugar levels, you don’t need to be forced into changing doctors every few years.
This means finding a good Medicare supplement (Medigap) plan you can keep as long as you live. With over 170 different Medigap plans in Georgia, we can help you find the one that fits your needs and budget.
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Medicare and Diabetes
If your diabetes has been under control for most of your life, consider yourself fortunate. I have friends that are diabetic, both type I and type II. Some have lived most of their life without major issues. Others have not.
Consider this. According to the Diabetes Care Project
- 26 million people in the US have diabetes
- 79 million have “pre-diabetes”, 7 million have UNDIAGNOSED diabetes
- More than 90% of diabetics are type II and obesity contributed to most of those cases
- The US spends $174 million each year to treat diabetics; $119 million in direct health care costs
- $1 out of every $3 spent by Medicare is to cover the cost of care for diabetes
- Diabetics have medical expenditures that are more than 2x that of non-diabetics
- The average annual cost of care for diabetics is $13,700 with $7,900 of that tied directly to the disease
- The costs of treating diabetes rose 41% from 2007 to 2012
The longer you have diabetes, the greater chance you have of incurring high medical costs and complications. This is not the time to manage your illness and out of pocket costs with a Medicare Advantage plan.
Medicare Coverage forDiabetes Treatment
Original Medicare Part B covers the cost of testing equipment and supplies, insulin pumps and therapeutic shoes.
Part B also covers regular screening, diabetes self management training, nutrition therapy services, A 1c and glaucoma testing and much more. Check out Publication 11022 for more details.
Oral medication and self injecting insulin (not for a pump) are covered by Medicare Part D.
Don’t get sucked into the deals that promise free diabetic supplies. If you get an unsolicited call offering FREE diabetic supplies, hang up. Diabetes Health has this to say.
Scammers often pose as federal employees or workers representing legitimate diabetes associations. They’re looking for Medicare and Social Security numbers, as well as other financial information, that they can use fraudulently on their own behalf or sell to criminal syndicates.
Fraudsters that actually do send diabetes supplies send supplies that are inferior in quality, and then turn around and fraudulently bill Medicare for the order. “Free” supplies offered include glucose meters, diabetic test strips, and lancets, as well as such items as heating pads, lift seats, foot aids, or braces.
If you get such a call, immediately hang up and call the fraud hotline (1-800-HHS- TIPS, 1-800-447-8477)
Medicare and Prescription Drugs
The weakest link in the Medicare program is Part D, the prescription drug plan. Nowhere is it more obvious than when it comes to covering the cost of diabetic drugs.
Insulin can be very expensive, especially if you use a pen instead of a needle. The NovoLog patient assistance program can be a financial lifesaver for those who qualify.
Other PAP’s (Patient Assistance Programs) are another option.
We will review PAP’s in more detail in a future post.
Don’t Pay Too Much for Your Medicare Supplement Plan
Almost every day we talk to people who have bought the wrong Medicare plan for their needs, are paying too much, or both.
We recently compared plans for a lady who lived in zip code 31630, was turning 65 and going on Medicare. After talking with her friends she had decided to buy plan F from either Blue Cross or United Healthcare (through AARP). She was told that plan F “pays everything” (which is true) and that she should go with a big carrier that will pay all her claims.
Of course no one told her that ALL the carriers pay 100% of the contractual claims approved by Medicare. The normal claim process is your doctor files with Medicare, Medicare approves the claim, your supplement plan pays their portion.
A routine claim will take a couple of weeks with Medicare and about another week with the Medigap carrier.
Any doctor that participates in Medicare will also accept ANY Medigap plan, regardless of the issuing carrier.
Blue was going to charge this woman $168 per month. She could save a few dollars with the AARP/UHC plan F for $166.
But she can save even more by using a carrier I represent that will pay her claims in the same manner as Blue and UHC but with a monthly premium of $126 per month. That $40 per month savings adds up quickly!
Maybe she should consider new friends.
Better yet, introduce me to her friends so they can save money too.
Diabetes can be expensive. Let us show you a number of ways to minimize your out of pocket costs.
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