Medicare changes coming for diabetics


A diabetic tests his level of blood sugar in Kamen, Germany. Medicare will open a national mail-order program for diabetes testing supplies that will drop the prices the government pays for those products. (The Associated Press)

Published: Wednesday, June 26, 2013 at 2:33 p.m.
Last Modified: Wednesday, June 26, 2013 at 2:33 p.m.

Washington

Medicare begins a major change next month that could save older diabetics money and time when they buy crucial supplies to test their blood sugar — but it also may cause some confusion as patients figure out the new system.

Beginning Monday, Medicare opens a national mail-order program that will dramatically drop the prices the government pays for those products but patients will have to use designated suppliers. The goal is to save taxpayers money but seniors should see their copays drop, too.

Don't care about the convenience of mail delivery? Just over half of the 4.2 million diabetics with traditional Medicare coverage used mail-order last year, but starting Monday beneficiaries also can get the new lower price at drugstores enrolled in the Medicare program.

It's the biggest expansion yet of a larger, and somewhat controversial, initiative that's predicted to save taxpayers nearly $26 billion over the next decade by cracking down on waste and fraud in the medical equipment industry.

Here are some questions and answers about the program:

Q: What's the big change?

A: Until now, hundreds of mail-order companies could bill Medicare for the test strips, lancets and other supplies that diabetics use to measure and track their blood sugar. Under the new national program, Medicare patients can order from only 18 mail-order companies that won government contracts and will be subject to more oversight. (The change doesn't apply to Medicare Advantage patients.)

Check the list at www.medicare.gov/supplier or by calling 1-800-MEDICARE. Some companies operate under multiple names.

Q: What if the new companies don't sell my brand?

A: Medicare's list shows different suppliers that sell a mix of top-selling brands as well as generics — and you're not required to change your existing monitor. But you may need to shop around or get a doctor's note that specifies you need a specific type, so plan ahead.

Q: What's the price difference?

A: Medicare has paid about $78 for 100 test strips and lancets, just over a month's supply for someone who tests his or her blood sugar three times a day. Remarkably, that rate was higher than other insurers typically pay. Starting Monday, that reimbursement will drop to about $22. The patient copay is 20 percent, so it will drop from about $15 to less than $5.

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