Q: I'm diabetic and get my blood testing supplies via mail order. When I called to order my next shipment I was told I would have to pay the full cost of supplies and my credit card was charged. I thought Medicare covered the cost.
A: Medicare has begun a major program change that affects diabetics who get supplies home delivered and other seniors who rent medical equipment like home oxygen gear and wheel chairs. The program is intended to help seniors save money when they buy supplies and rent equipment, but TSCL believes it is more likely to first cause confusion and surprise unanticipated costs until patients figure out the new system.
Adding to the confusion, the program will affect beneficiaries differently depending on the area of the country in which they live, and how they are getting their supplies and durable medical equipment. Effective July 1, 2013, in most cases if you have "Original" Medicare coverage and get items in the new program areas, Medicare will only help pay for these items if they’re provided by contract suppliers.
If you buy your diabetic testing supplies through mail order, you MUST get your supplies through contract suppliers in Medicare's new National Mail Order Program in order for Medicare to pay. This applies to beneficiaries living in all parts of the United States. Medicare defines mail order as all home deliveries.
National mail order contract suppliers can't charge you more than any unmet deductible and 20 percent coinsurance. To find a contract supplier for your area, call 1-800-MEDICARE (1-800-633-4277), or visit www.medicare.gov/supplierdirectory. The online tool will allow you to select the type of supplies you need and provides a complete list of mail order suppliers and their phone numbers serving your area.
If you don't want diabetic testing supplies delivered to your home, you can go to any local store that is enrolled in Medicare and buy them. Ask if the local store accepts "assignment" or the Medicare approved amount as payment in full. If they do not, the store may charge more than the 20 percent coinsurance and any unmet deductible. Shop around. Call your local stores and find out what your copayment would be first if you decide to pick up supplies instead.