Benefits of insulin through Medicare part b vs part d

Our retirement benefit has remained mostly the same but changed the Pharmacy Benefits Manger for part D to Silver Scripts (CVS) One of the changes is that they don’t handle Humalog, but Novolog, fine by me as Humalog tends to be less effective on day 3.

My question is that insulin for a pump is suppose to be under Part B DME supplies. What is the advantage to having it paid by Part B as opposed to Part D?

How do i get it charged to Part B? CVS seems clueless about Part B.

One plus with the change is that Afrezza is in the formulary, I was wanting to try it for those stubborn highs.

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@CarlosLuis Most direct answer regarding Part B vs D: Using myself as an example with retired military Tricare for Life (TFL) coverage, what Medicare doesn’t cover regarding prescriptions is pretty much covered by TFL; example I pick-up my insulin pens, that I use in my pump, at a military pharmacy for free, or with a variable co-pay via a network pharmacy or mail-order as long as the insulin is in the military formulary (some require Pre-Approval or Medical Necessity, like Afrezza was just added with PA/MN). So I only have Medicare A and B, not D. Others with secondary coverage (not Part D) probably have similar coverage. I don’t think it’s possible to get insulin changed from Part D to B; Part B coverage is what Medicare says it is. My understanding is Medicare currently says the DME (Durable Medical Equipment) portion covers “some” pumps and the insulin for the “some” pumps as long as it doesn’t come in pens or cartridges for pens. Otherwise, insulin is only covered by secondary insurance or Medicare Part C or D. Medicare also says Part B does not cover syringes, alcohol swabs, inhaled insulin, or bandages. So people like me that use insulin pens, instead of vials, as the source of insulin need secondary insurance, a Part D plan, or a Part C plan that extends coverage to pens/cartridges as an insulin source.

When thinking of Medicare, I can’t help but think of the MASH episode where I think it’s LTC Blake asking Radar if he understand the Army’s system. Radar’s response, “Oh no sir, that just slows down the paperwork!” And yes, I’m dating myself again, but a classic is a classic!

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