"Mack" <[email hidden]> wrote in message
"]news:[email hidden]...
Quoted message said:On Thu, 5 Feb 2004 09:04:47 -0500 (EST), [email hidden] (Micki
:
Quoted message said:
do you think you could post the process and requirements? if there are specific forms to fill out
we could link to them if they are available for download or we could post them up on website if
you can get copies would could scan.
Mack Type 1 since 1975
And I have been receiving this benefit for a year! I did announce it to the group but most who read
it said that it couldn't be true. Well, it is and now there are 2 of us. I am glad Micki heeded the
advice and pursued it to completion because everyone wants to deny it (meaning the
pharmacists/suppliers and doctors are not really informed about it). I will say that Liberty Medical
does have on their site the fact in black and white that Insulin for Pumps is a covered item. But,
of course, you must meet the Medicare requirements listed below along with seeing a doctor who
treats many with pumps, every three months, keep accurate testing records. Very important is the low
C-Peptide.
Anyone who is having pump supplies provided by Medicare (which would mean they have submitted the
appropriate C-Peptide level of 0.5 or less) is eligible. Micki's forms are not going to help so much
as one needs to contact the Durable Medical Supply section of Medicare for their geographical area.
Then, get a listing of what pharmacies, suppliers are a Medicare provider from the agent to whom you
speak.. That company will provide the forms which you must take to your doctor and have filled in
appropriately. Return the said forms to the provider (pharmacy, clinic, whatever) who will then put
it through their Medicare section and soon enough, there you are, insulin provided (well, 80% which
is big chunk for Humalog).
The whole program works on the durable medical thing...the pump, the durable medical equipment must
have insulin to run. Therefore, the insulin becomes part of the durable medical situation.
So, to sum it up: Call your area (find it on the Medicare site or in your Medicare booklet) durable
medical representative at Medicare. (Mine was in PA, for RI)
Find a suitable Medicare provider.
Get the papers from the provider.
Take them to your doctor to be filled in.
Return the completed papers to the provider and you should be all set if you fulfill all the qualifications(C-
peptide, pump, etc.)
My experience with Brooks Pharmacy was abysmal. The pharmacist treated me as if I were stupid, that
nobody gets insulin paid for by Medicare. I had already spoken with my Durable Medical Medicare Rep,
who was so helpful and kind, had reassured me that , yes, it is covered and do not pay up front! Not
so with Brooks, they wanted nothing to do with it and were nasty. Needless to say, Brooks is a
pharmacy that will never see one of my dollars( or anyone of my family's either) for the treatment I
got there.
Next, I called Walgreen's. The pharmacist said he did not know anything about it, but would check
it. Called back to tell me that it was easier than he thought! Walgreen's came through beautifully!
So having the forms is not necessarily going to help because it all hinges on which
supplier/provider you will use. They (at least in my case) had the forms in their own Medicare
departments.
I am just happy that my experience has made insulin coverage by Medicare a reality for someone else.
Hope others reading out experience here will also benefit from it. It is there, it is just not very
well known. And when I talked of it here for the first time, nobody believed it and so...Maybe now.
--
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