How to avoid paying a copay for diabetic supplies when you are on Medicare

Why do I keep getting a copay for my monthly diabetic supplies when my Insurance agent said it would be covered at 100%?

The way it should work

When you get your Diabetic supplies filled each month at the pharmacy, the pharmacy should be billing Medicare Part B. Your Medicare supplement will then pick up the balance. When they are billed this way, the diabetic supplies are covered at 100%.  Unfortunately for the pharmacy, when they bill Medicare Part B they are reimbursed considerably less than if they bill Medicare Part D.

Why I get a copay

The reason people on original Medicare and a Supplement get these $20 to $50 a month copays for diabetic supplies is quite simple. When you present all of your cards to your pharmacy they are generally not billing Medicare Part B, but instead billing your Medicare Part D carrier. When a pharmacy does this they will receive a larger reimbursement from the Part D carrier then they would with Medicare Part B.

Unfortunately, some pharmacies will refuse to accept Medicare Part B reimbursement for diabetic supplies.   Some local pharmacies are more notorious than others for this policy.  The advice we give here at Steinlage Insurance Agency is to always call your specific pharmacy and verify that they will accept Medicare Part B reimbursement.  Make sure it is your specific, physical pharmacy you are using because this can vary from store to store, even if they are all owned by the same company.

As, always Steinlage Insurance Agency is keeping an eye out for are local seniors and providing tips to keep as much of your hard earned money in your pocket.