This was taken today 06/15/2016 from Medicare.gov’s website so that people who have Medicare and use Diabetic Testing Supplies, know how MEDICARE’S Mail Order works.
Medicare’s National Mail-Order Program for diabetes testing supplies
The National Mail-Order Program doesn’t require you to change your testing monitor. If you’re happy with your current monitor, look for a mail-order contract supplier or local store that can provide the supplies you need for your monitor.
If you switch suppliers, you might need to arrange to have your current prescription transferred or get a new prescription for testing supplies from your doctor. Plan ahead before you run out of supplies.
How much will I pay if I buy supplies at a store?
You’ll pay the same amount for diabetes testing supplies whether you buy them at the store or have them delivered to your home. National mail-order contract suppliers can’t charge you more than any unmet Part B deductibleand 20% coinsurance. Local stores also can’t charge more than any unmet Part B deductible and 20% coinsurance if they accept Medicare assignment. Local stores that don’t accept assignment may charge you more. If you get your supplies from a local store, check with the store to find out what your payment will be.
The National Mail-Order Program applies to Original Medicareonly. If you’re enrolled in a Medicare Advantage Plan (Part C)(like an HMO or PPO), your plan will let you know if your supplier is changing. If you’re not sure, contact your plan.
What if I need a specific brand of equipment or supplies?
If you need a particular brand or mode of delivery of an item or service in order to avoid an adverse medical outcome, your doctor must prescribe the specific brand or mode of delivery in writing. Your doctor must also document in your medical record why this specific brand or mode of delivery is needed in order to avoid an adverse medical outcome. In these situations, a Medicare contract supplier is required to do one of these:
- Give you the exact brand or mode of delivery of the item or service your doctor authorizes for you.
- Help you find another contract supplier that offers that brand or mode of delivery.
- Work with your doctor to find an appropriate alternative brand or mode of delivery and get a revised written prescription.
Can my contract supplier switch me to a different brand?
No. Contract suppliers must give you the brand of testing supplies that works with your testing monitor. If the contract supplier doesn’t carry your brand of testing supplies, you can ask the contract supplier about other brands they offer. However, the supplier can’t start this conversation.
What if I have other insurance?
If your primary insurance policy requires you to use a supplier that doesn’t participate in the national mail-order program, Medicare may make a secondary payment to that supplier. The supplier must meet Medicare enrollment standards and be eligible to get secondary payments. For more information, check with your insurer, plan provider, or benefits administrator.
What if suppliers call and ask me to switch suppliers?
Medicare has rules to protect you from unsolicited phone calls from suppliers. If you think you’ve been pressured to switch suppliers, we strongly encourage you to take one of these actions:
- Call 1-800-MEDICARE (1-800-633-4227).
- Report fraud using the HHS Office of Inspector General’s online form.
- Call the Fraud Hotline of the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477).
What if people try to send me free supplies that I didn’t order?
- Don’t accept items that you didn’t order. Refuse the delivery and/or return it to the sender. Keep a record of the sender’s name and the date you returned the items.
- Call 1-800-MEDICARE or the Fraud Hotline of the HHS Office of Inspector General at 1-800-HHS-TIPS.