MEDICARE

MEDICARE COVERAGE

Medicare now covers blood glucose monitors and testing strips for all Medicare Part B enrollees with diabetes. Previously, only patients who were insulin treated qualified for this coverage. The new benefits mean that Medicare will reimburse for blood glucose monitors and testing supplies for people not using insulin. Medicare will also continue to allow patients using insulin to obtain strips and blood glucose monitors.

     Your doctor must prescribe the home blood glucose monitor and determine that you or another responsible individual are capable of operating the device. (We can help with this part.)
     The monitor itself must be designed for home use in order to be covered under this benefit of Medicare Part B. (Most are and relatively simple to operate.)
     If you have severe visual impairment, you may qualify for reimbursement of a monitor with special features for the visually impaired.

What is covered?

Your Medicare coverage allows you to receive reimbursement for your monitor, test strips, lancets, and a spring powered lancet device.
Once you own a home blood glucose monitor, a claim for your test strips and lancets should be submitted to Medicare on a monthly basis as you purchase your supplies for each month. (We can help with this part.)

Test Strips and Lancets for Insulin-Treated Diabetes: Medicare will pay for up to 100 test strips and 100 lancets every month for use by a beneficiary who is insulin treated diabetic. Medicare will pay for more than 100 test strips and lancets if the physician documents the beneficiary's need to test blood sugars more often.

Test Strips and Lancets for Non-Insulin-Treated Diabetes: Medicare will pay for up to 100 test strips and 100 lancets every three months for use by the beneficiary. Medicare will pay for more than 100 test strips and lancets every two months for non-insulin-treated beneficiaries if one of the following indicators is present:

-Management of medical condition by adjusting therapy and/or oral agents; or
-Detection of hypoglycemia when symptoms are present.

If your physician is treating your diabetes and feels you would benefit from home blood glucose monitoring, or you are currently monitoring your blood sugar levels and paying out-of-pocket for your supplies, we can help you get the supplies you need covered and bill Medicare for you. More Info

Call us at 800-544-5433 and we will help you determine your coverage.

Blood Glucose testing is currently the only method available to patients with diabetes to monitor blood sugar levels and make necessary adjustments in the day-to-day management of their disease.
Studies have shown that by maintaining consistent and healthy blood sugar levels, people with diabetes may delay the onset and even prevent the disease's complications, including blindness, amputations, heart disease, and kidney failure. By testing your own blood sugar levels, you can track your insulin therapy and lifestyle, and make adjustments in your therapy to ensure long term progress and health.

The Following Supplies Are Not Covered!

Insulin, Syringes, Needles, Alcohol, Peroxide, Alcohol Wipes, Betadine, Phisohex, Betadine Wipes, Iodine Wipes, Cotton Swabs, Urine Test Strips.

CALL US! 1-800-544-5433

Our service representatives can answer your questions and get you started today.

If you are a Type II or Type I diabetic, call Diabetes Home Care at 1-800-544-5433 for more information on how you can qualify for these services.

How Do I Qualify?
Medicare pays for blood glucose monitors and test strips if the physician treating the beneficiary's diabetic condition documents that the beneficiary or care giver is capable of being trained to use the monitor and the monitor is designed for home use. (Most monitors are designed for this purpose and simple to operate.) All applicable Medicare deductibles and co-payments will apply to these benefits.

Test Strips and Lancets for Insulin-Treated Diabetes- Medicare will pay for up to 100 test strips and 100 lancets every month for use by a beneficiary who is an insulin treated diabetic. Medicare will pay for more than 100 test strips and lancets per month if the physician documents the beneficiary's need to test blood sugars more often.

Test Strips and Lancets for Non-Insulin-Treated Diabetes- Medicare will pay for up to 100 test strips and 100 lancets every three months for use by the beneficiary. Medicare will pay for more than 100 test strips and lancets every two months for non-insulin-treated beneficiaries if one of the following indicators is present:

-Management of medical condition by adjusting therapy and/or oral agents; or
-Detection of hypoglycemia when symptoms are present.

How do I get started?

Just call Diabetes Home Care. 800-544-5433

Our friendly staff will help determine your coverage and assist you in obtaining the proper documentation for coverage.

If your physician is treating your diabetes and feels you would benefit from home blood glucose monitoring, or you are currently monitoring your blood sugar and paying out-of-pocket for your supplies, we can help you get the supplies you need covered and bill Medicare for you.

Here's a Legislative summary of the new law:

Balanced Budget Act Of 1997 Medicare and Medicaid Provisions

Diabetes Self Management (Section 4105)

Provisions

Provides coverage for diabetes outpatient self-management training to include services furnished in non-hospital-based programs (already covered in hospital based programs.) Services may be provided by physicians or other entities designated by the Secretary it they also provide other services paid by Medicare and meet quality standards established by the Secretary. A physician managing the patient's condition must certify that the services are needed under a comprehensive plan of care. Services will be paid under the physician fee schedule in amounts set by the Secretary in consultation with appropriate organizations.

Provides coverage for blood glucose monitors and testing strips for all diabetics (already covered for insulin-dependent diabetics). Payment for testing strips used with blood glucose monitors will be reduced by 10 percent.

Requires the Secretary to establish outcomes measures for evaluating improvements in the health status of Medicare beneficiaries with diabetes, and to periodically submit recommendations to Congress on modifications to coverage of services for diabetics.

Effective Date:

Type II Coverage-Prospective Date of July 1, !998