I am not trying to stir the pot of frustration about Medicare and Dexcom … but here goes.

screenbean-phoneAs I mentioned, Dexcom absolutely CANNOT sell me any product, for cash, because my file shows that I am covered by Medicare.  Even if I just want to BUY a transmitter CASH, the answer is NO.  They are referring everyone over to Liberty Medical Supplies in Port St. Lucie, FL, only open from 8am-5pm EST. 

I finally was able to get to my desk early enough to call them today … and I sat on hold for 42 minutes.  I finally reached a lovely rep named Liana (they’ve all been very pleasant).

 

Here’s today’s scoop:

  1. I first had to register as a new patient with Liberty … no problem, as, for some reason, I was already in their database?!
  2. Then they will request a new prescription from my endocrinologist … also no problem, even though there is one on file with Dexcom.
  3. Next, she emailed me the ABN (Advance Beneficiary Notice of Noncoverage) form.  AHA, there’s where I learned a lot!

Medicare will cover orders as follows:

  • Dexcom G5 Kit, a 90 day supply for $745.14, which may include
    • 1 Transmitter
    • 3 boxes of sensors
    • 4 boxes of test strips, 2 meter batteries
    • 1 blood glucose meter (brand unidentified), even if I don’t need one
  • Dexcom G5 Receiver, for $277

After I submit this form, on which I choose whether I want them to bill Medicare, not to bill Medicare or not to order supplies, I can then call and place my order.  Remember, today’s call lasted 62 minutes.

I was reminded that I would be fully responsible for $745.14 if I do not qualify under the Medicare criteria, which have not yet been published! 

In other words, I will place an order, for things I do not need (because that is how Medicare is bundling it), without any assurance that I will meet the criteria for coverage and end up paying their cash price and filing another appeal with Medicare. 

3d man with what next sign boardThis amazing diabetes community has made it possible for me NOT to worry yet about being without supplies.  And maybe I’m just impatient. 

BUT, ordering parts I don’t need without a guarantee that it is even covered … just another major diabetes stressor!

 

 

scr ohmWhat do you think?

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