FUDiabetes

How to get Freestyle Libre approved by Medicare

Finally

I got approved for Freestyle Libre. 14 day
Yes it really took this long. Mistakes were made and it cost a lot of time.

Step 1: Call your Medicare Advantage provider and ask for medical. Ask them for the name and number of your approved Durable Medical Equipment Provider.

Step 2: Call The Equipment provider and tell them you need Freestyle Libre. Have your

doctors Contact information Name, Phone number, Fax Number and email if possible.

Also have your Insurance information.

Step 3: Wait !! I suggest you follow up with calls to the provider and doctor to see if things are getting done. The doctor has forms to fill out and you will get a form to allow charges to your insurance. Once the forms are done the Equipment provider will submit them to your insurance.

Step 4: Wait some more for your insurance to approve or deny based on the doctors forms.

Step 5 If you are approved you will receive your first shipment.
Medicare pays 80%

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@tduke, great news!

How long did it take in the end?

[EDIT] This is worth its own thread!

@tduke Thanks for the great information! I tried to help my mom get the libre earlier this year, and we were denied. But you’ve given me hope, and now I know what to do! Congratulations on your improved A-1 C, and all of your hard work has paid off! Yay!

It took us over a month to get her a meter and strips - what a debacle! Luckily my partner has T1, and lent her a spare meter and strips. But Medicare would cover it - I think it was the pharmacy who wasn’t willing to work with us. I called around and found a new Medicare Part B pharmacy (Vons in our town does it; Costco - her Part D pharmacy - does not) and now it works great!

Stop with the pharmacy, my first mistake, go to the Durable Equipment Supplier. It took me over a month because of mistake with a pharmacy.

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My sister and I are both Type 1s. When the Libre became available in the U.S. (TWO YEARSafter Europe!) we both applied when told Medicare Part B would cover ALL expenses. She’s on Blue Cross Blue Shield of North Carolina, I’m on BCBS of Michigan. She got hers in a week and could order it from a number of suppliers (she got hers from an Ohio supplier). It took me six weeks and I had to order it from only one, very poorly reviewed, supplier. This, of course makes no sense, unless, there are under the table payoffs involved. That could be the only reason. With all the government workers we pay, why isn’t this issue being investigated? And interestingly neither the supplier nor BCBS Michigan had a simple printed list of requirements to quickly refer to ONE TIME! Everytime we supplied some required statement or document, there was another one that popped up. Both the supplier (J & B Medical) and BCBSMi are managed by idiots. Then there is the greed factor…

Part II: I paid the 150 to the supplier who got the back bill from BCBSMi so I can get sensor refils. Yesterday I filed a "grievence" with BCBSMi, protesting the chargeback. Always very nice people to deal iwth on the phone, I was told the process is likely to take a month! Next: a nice chat with my local CMS Medacare representative. I think the 150.67 (don’t forget the 67 cents!) got me seven 14 day sensors.

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