You may already know that Medicare is a federally funded health insurance program that primarily covers people who are over 65 years of age. You may also know that since 1998, Medicare Part B (the optional part for which you pay a monthly premium) covers blood glucose monitors, blood glucose strips, lancets and other related testing supplies as long as they are prescribed by your health care provider. What you may not know is that a significant change took place last year: You no longer can submit claims for your diabetes supplies on your own; your claims now must be submitted by your pharmacist. This is called assignment.
WHAT IS ASSIGNMENT AND HOW DOES IT WORK?
When a claim is assigned to a provider (such as your pharmacy or physician), you are telling the provider to receive payment directly from Medicare. This decreases your out-of-pocket cost because your provider submits the claim to Medicare and Medicare pays 80% of the bill to them directly. You are only charged 20% upfront. Walgreens now accepts Medicare assignment, so ask your Walgreens pharmacist for more details.
WALGREENS OFFERS MORE HELP
Walgreens also has developed a program that enables you to purchase three month’s worth of diabetes supplies at a time. Walgreens accepts assignment on the following brands:
- Accu-Chek Active
- Accu-Chek Comfort Curve
- Accu-Chek Compact
- Ascensia AUTODISC
- Ascensia Elite
- FreeStyle
- Walgreens brand (TrueTrack and Prestige) other changes to Medicare Part B
There are several other revised benefits from Medicare. Even if you are not on Medicare, these changes are important to know about because other health insurance plans look at Medicare as a guide.
NOW COVERED BY MEDICARE PART B
- Ten hours of initial group diabetes self-management training (this is a one-time benefit only) and two hours per year of follow up. The self-management training program must be recognized by the American Diabetes Association, and you must have a referral from your health care provider or nurse practitioner. To find programs in your area, contact the ADA at (800) DIABETES.
- Three hours of individual medical nutrition therapy with a registered dietitian. Not all dietitians are accredited Medicare providers, so ask before you make an appointment.
- Dilated eye exams to screen for glaucoma for people with diabetes.
- Annual foot examinations by a podiatrist for those with neuropathy, a degenerative nerve condition that causes some people with diabetes to lose sensation in their feet. Therapeutic shoes also are covered for people with neuropathy and some other foot problems diabetes causes. A maximum of one pair of shoes and three pairs of inserts are covered.
*Please note: copay and deductible still apply.
WHEN IN DOUBT
You may not be sure what Medicare or your health plan covers. Contact Medicare’s help line at the toll-free number (800) MEDICARE or review the Web site medicare.org. Whether you have your own health plan or have it through your spouse’s employer, check with the benefits office or call the number on your health plan card. They can outline what you are entitled to receive and give advice if you are denied coverage for something you believe is a covered benefit.
For Medicare Questions
- Talk to your Walgreens pharmacist
- visit walgreens.com/medicare
- or call the medicare helpline at (800) Medicare
