I experienced a Medicare cut back

[manning]

Or Walgreens is playing games.

I'm diabetic. Medicare always paid for the test strips. I just picked up some today and they wanted a $15.00 co-pay.

 

[sookie]

OK.
Pay the co-pay. Sounds like a very reasonable co-pay to me.

 

[kidzmom3]

If you have MCR part B there should be no cost for test strips as long as they have a current, up to date prescription on file.

If you have a MCR replacement plan such as Tuftsmcr or Securehorizons, you would have a copayment.


from CMS, which is MCR for anyone unsure. "Those who use insulin should be covered for up to 100 test strips and lancets every month, and one lancet device every 6 months. Those who do not use insulin should be covered for up to 100 test strips and lancets every 3 months, and one lancet device every 6 months.

If the patient's physician states in writing that it is "medically necessary," Medicare will often allow coverage for additional test strips and lancets."

 

[jt'smom]

OK.
Pay the co-pay. Sounds like a very reasonable co-pay to me.

my husband is a diabetic and went without testing his sugar for 6 months and had to use 1/4 of his normal insulin because it was going to be $600 a month when he lost his job and health insurance. we would have been THRILLED to have a $15 copay for strips

 

[vicki_c]

Just curious as to whether the OP asked Walgreens why there was suddenly a copay and what they said vs. just assuming that the Medicare plan changed.

 

[happygirl]

OK.
Pay the co-pay. Sounds like a very reasonable co-pay to me.

Might be reasonable for you but not for everyone.

 

[amg35]

You should have received notification if there was a change in your benefits.

Call and ask for an explanation of benefits, that will let you know what you are expected to pay in co-pays

 

[BearcatsFan]

Just curious as to whether the OP asked Walgreens why there was suddenly a copay and what they said vs. just assuming that the Medicare plan changed.

I was wondering the same thing. OP, check back in and let us know. Maybe they changed the kind of strips they will cover in full?

I'm a diabetic not on Medicare. My strips are $60/100, but it also depends on what brand strips I use. Only certain brands are available for that co-pay.

 

[amg35]

Might be reasonable for you but not for everyone.

Most insurance plans have these types of co-pays. Certainly more reasonable than paying completely out of pocket.

 

[sookie]

Might be reasonable for you but not for everyone.

And many people would be doing the happy dance for that copay. Some people would be happy they could have the option to get strips at that price at all.

OP, call and check your benefits and see what they are. If you are paying a premium for part B, you shouldn't be paying a co-pay like a previous poster said. Did they give you extra strips maybe? Or give you a premium brand? If nothing changed and the co-pay is correct, that is still a very, very good cost to you as a patient for testing strips. Diabetic care is very expensive. You might be able to get a better price if you pick up 90 days worth - you might be able to pay for two months and get a 90 day supply. Call your insurance and ask. Do you have a secondary insurance as a retiree? Maybe they just need your information on file?

Medicare is a federal plan, and we all pay for that coverage. The OP paid in, of course, but so does everyone else. Diabetes is a very, very, very high cost disease. A $15 dollar copay? A drop in the bucket, if that is the OP's cost. I'm glad he/she has this coverage, as a lot of retired people have a limited budget. Test strips are majorly expensive. This limits the OP's cost. To ask a person to kick in $15 dollars towards the cost of strips is very reasonable overall. The patient can always contact the plan and see if there is something different she can do to help with that copay cost. If they are really indigent, there are often other resources of diabetics that can help with costs.

I've got my flame suit on.

 

[mhsjax]

And many people would be doing the happy dance for that copay. Some people would be happy they could have the option to get strips at that price at all.

OP, call and check your benefits and see what they are. If you are paying a premium for part B, you shouldn't be paying a co-pay like a previous poster said. Did they give you extra strips maybe? Or give you a premium brand? If nothing changed and the co-pay is correct, that is still a very, very good cost to you as a patient for testing strips. Diabetic care is very expensive. You might be able to get a better price if you pick up 90 days worth - you might be able to pay for two months and get a 90 day supply. Call your insurance and ask. Do you have a secondary insurance as a retiree? Maybe they just need your information on file?

Medicare is a federal plan, and we all pay for that coverage. The OP paid in, of course, but so does everyone else. Diabetes is a very, very, very high cost disease. A $15 dollar copay? A drop in the bucket, if that is the OP's cost. I'm glad he/she has this coverage, as a lot of retired people have a limited budget. Test strips are majorly expensive. This limits the OP's cost. To ask a person to kick in $15 dollars towards the cost of strips is very reasonable overall. The patient can always contact the plan and see if there is something different she can do to help with that copay cost. If they are really indigent, there are often other resources of diabetics that can help with costs.

I've got my flame suit on.

My portion for my DD's test strips was $45.00. and he has Blue Cross Federal employee. I would love to pay $15.00, HOwever I do realize that many people on Medicare are on a very tight budget and who knows what all the other supplies and meds are costing.

 

[happygirl]

And many people would be doing the happy dance for that copay. Some people would be happy they could have the option to get strips at that price at all.

OP, call and check your benefits and see what they are. If you are paying a premium for part B, you shouldn't be paying a co-pay like a previous poster said. Did they give you extra strips maybe? Or give you a premium brand? If nothing changed and the co-pay is correct, that is still a very, very good cost to you as a patient for testing strips. Diabetic care is very expensive. You might be able to get a better price if you pick up 90 days worth - you might be able to pay for two months and get a 90 day supply. Call your insurance and ask. Do you have a secondary insurance as a retiree? Maybe they just need your information on file?

Medicare is a federal plan, and we all pay for that coverage. The OP paid in, of course, but so does everyone else. Diabetes is a very, very, very high cost disease. A $15 dollar copay? A drop in the bucket, if that is the OP's cost. I'm glad he/she has this coverage, as a lot of retired people have a limited budget. Test strips are majorly expensive. This limits the OP's cost. To ask a person to kick in $15 dollars towards the cost of strips is very reasonable overall. The patient can always contact the plan and see if there is something different she can do to help with that copay cost. If they are really indigent, there are often other resources of diabetics that can help with costs.

I've got my flame suit on.

A lot of people on medicare are on very very tight budget. A lot of senior citizens that can't afford 15 dollars.

 

[amg35]

Well, let's hope we don't get rid of Medicare altogether.

 

[Nancy for Disney]

A lot of people on medicare are on very very tight budget. A lot of senior citizens that can't afford 15 dollars.

I agree. I would find out why there is a change.

 

[Ephany]

Some boxes of 100 count strips are almost $140. If someone tests 4-6 times per day, that's a lot of money out of pocket each month. I've also seen many, many signs along the side of the road here stating to call this number and they'll pay cash for strips. Maybe an increase in co-pays is designed to help ensure that Medicare isn't paying for strips that some people then turn around and sell?

I'm not knocking the OP, it's definitely a shock to go from no copay to $15, even if it's a great price compared to what many others pay. I'd definitely call your insurance and see what changed. Also, Medicare is getting more and more strict about how the prescription is written. I'd also ask the pharmacy if they know what changed or if they've seen this happen with other patients. Good luck.

 

[ORMom2Four]

And many people would be doing the happy dance for that copay. Some people would be happy they could have the option to get strips at that price at all

I've got my flame suit on.

I am on insulin, 4 injections a day, and rarely test because the strips are so expensive. I know it must have been a surprise to have to pay $15, but it's not all that much when you see what the retail price is on them.

 

[cm8]

I am on insulin, 4 injections a day, and rarely test because the strips are so expensive. I know it must have been a surprise to have to pay $15, but it's not all that much when you see what the retail price is on them.

I am sorry to hear that. What kind do you use For everyone that is not testing or skipping the recommended amount of testing what brand are you using. There are programs out here that you will qualify for free Test Strips and supplies that won't cost you anything if you meet requirements

Are you all making your Physician aware of the money issue We have tons of supplies that we give away when a Patient needs them. We can no longer volunteer them but if you ASK it shall be given to you.

OP, do you plan on coming back to tell us what happened

 

[Sadie22]

OP, the clerk may have made a mistake. Definitely go back and ask for a manager to help you.

My company that makes my meter has a discount program so that I would not have to pay more than a certain copay at a retail pharmacy. I have insurance and get my supplies through mail order. The meter company has given me free strips when i needed a new meter, and my doctor has given me free strips, so your doctor may have some. Supplies are donated to our local Office on Aging for the use of those in need. The local department of social services might also be able to help those in need.

 

[asta]

Just be glad you have Medicare instead of private insurance. I'm not old enough for Medicare so I have coverage through my old employer's plan and they argue with everything. They refused to pay to refill my lancets because the prescription did not match in quantity to the strips. I argued with them until I decided to just prick my finger with a straight pin. The insurance company also disagreed with the amount of Metformin that my doctor prescribed and refused to refill it. Thank goodness it was cheap enough that I could pay out of pocket until I could convince the doctor to accept the judgement of an insurance clerk over his advice.

After arguing with them I am convinced that my drug plan is just trying to wear me down until they don't have to pay for my prescriptions. Private insurance companies are only interested in their bottom line and profits. Getting rid of Medicare and issuing vouchers for private insurance is a terrible idea.

 

[ORMom2Four]

I am sorry to hear that. What kind do you use For everyone that is not testing or skipping the recommended amount of testing what brand are you using. There are programs out here that you will qualify for free Test Strips and supplies that won't cost you anything if you meet requirements

Are you all making your Physician aware of the money issue We have tons of supplies that we give away when a Patient needs them. We can no longer volunteer them but if you ASK it shall be given to you.

OP, do you plan on coming back to tell us what happened

Just be glad you have Medicare instead of private insurance. I'm not old enough for Medicare so I have coverage through my old employer's plan and they argue with everything. They refused to pay to refill my lancets because the prescription did not match in quantity to the strips. I argued with them until I decided to just prick my finger with a straight pin. The insurance company also disagreed with the amount of Metformin that my doctor prescribed and refused to refill it. Thank goodness it was cheap enough that I could pay out of pocket until I could convince the doctor to accept the judgement of an insurance clerk over his advice.

After arguing with them I am convinced that my drug plan is just trying to wear me down until they don't have to pay for my prescriptions. Private insurance companies are only interested in their bottom line and profits. Getting rid of Medicare and issuing vouchers for private insurance is a terrible idea.

My Dr and my diabetes nurse are very aware of my insurance plan. We have Kaiser. If they were private Dr's, they might be able to offer more help, but as Kaiser Dr's, they are stuck with Kaiser rules.

I've used the same lancet for the past 6+ months. I also re-use insulin needles, only switching to a new one when the old one is so dull it does not penetrate the skin without a lot of pressure. I've bought insulin and supplies on Craigslist. On Jan 1st, I will no longer have coverage for my insulin until my $3000 deductible is met, and prescriptions do not count towards the deductible. At that point, if I don't find any insulin on Craigslist, I will probably go off insulin. (I use 5 vials of R, and 6 of N per month. That is a lot of $$$ and we cannot afford to pay retail for it)

I'd LOVE to have a $15 co-pay!

Sorry, didn't mean to hijack the thread, but when I hear that people get free (or even $15) diabetes supplies, I get just a little bit jealous