Marci’s Medicare Answers: Some diabetic supplies covered
I have diabetes and I am about to become eligible for Medicare. Does Medicare cover diabetic supplies?
Yes, Medicare covers certain diabetic supplies, such as glucose monitors and control solutions, lancets and test strips. Medicare covers these supplies in limited quantities, even if you don’t use insulin. If you use an insulin pump, the insulin and the pump may be covered as durable medical equipment under Medicare Part B.
For the supplies listed above, Original Medicare Part B (medical insurance) will pay 80 percent of the Medicare-approved amount, after you’ve met the yearly Part B deductible (the amount you must pay out of your own pocket before Medicare begins to pay).
In most cases, you or your supplemental policy will be responsible for paying the remaining 20 percent coinsurance. If you have a Medicare Advantage plan (Medicare private health plan), you should call your plan to find out what rules and costs apply.
If you need insulin and you inject your insulin with a needle (syringe), the Medicare prescription drug benefit (Part D) will cover the insulin and the supplies you need to inject it, such as syringes, alcohol swabs and gauze. Check with your prescription drug plan to make sure the insulin and any other medications you take to treat your diabetes are covered by the plan.
If you have Original Medicare and you would like more information on Medicare coverage of diabetic supplies, contact your Durable Medical Equipment Medical Administrative Contractor by calling 800-MEDICARE. If you have a Medicare Advantage plan or a Part D plan, contact your plan to find out what supplies are covered and what rules apply.
I have COBRA coverage through my former employer and I will be eligible for Medicare soon. Should I sign up for Medicare if am covered by COBRA?
Yes, you should sign up for Medicare as soon as you become eligible, because you are not entitled to a Special Enrollment Period when COBRA ends. It’s important that you enroll in Part B immediately, because you may be penalized for not doing so when you first became eligible for Medicare. COBRA coverage usually ends on the day you enroll in Medicare.
If you don’t sign up for Part B when you become eligible for Medicare, you may have to wait until the General Enrollment Period (Jan. 1-March 31) to enroll. If you sign up for Part B during that time, your coverage will begin July 1 of that year.
COBRA is the federal law that gives you the right to continue your health insurance once it ends because of job loss, divorce, death or other reasons. It is also known as “continuation coverage” and acts as a secondary payer to Medicare. This means that Medicare pays first on any health care services you receive and COBRA pays second. COBRA is not considered current employer insurance.
You should enroll into Medicare when you become eligible to ensure that you have primary health insurance and to avoid any gaps in your health care coverage.
Keep in mind that even if you sign up for Medicare when you are eligible, your spouse and dependents may keep COBRA coverage for up to 36 months. Contact your employer benefits group administrator to ask about your benefits and to notify them that you will soon become eligible for Medicare.
I didn’t sign up for Medicare Part B on time because I was worried that I wouldn’t be able to pay the monthly Part B premium. I have very limited income and was told that I need to sign up for Medicare in order to have my health care services covered. Are there any programs that can help me?
Yes, you might qualify for a Medicare Savings Program, which is an assistance program that helps people with limited income pay for the Medicare Part B premium. While the primary purpose of an the program is to help pay Medicare premiums and Medicare-related costs, another benefit of this program is that by enrolling you are automatically enrolling into Part B. They also eliminate any premium penalties you may have for delaying enrollment into Part B.
To qualify, you must have Medicare Part A and meet certain income and asset guidelines. Eligibility limits vary by state, so you should contact your State Health Insurance Assistance Program to find out whether you qualify.
Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights. org), the nation’s largest independent source of information and assistance for people with Medicare. To speak with a counselor, call 800-333-4114.