Medicare questions

Anyone on Medicare? I just turned 65 and now the pharmacy is telling me that Medicare doesn’t cover Dexcom, not on Pharmacy benefits (Part D) or on Part B (durable medical equipment). Can this be true? CGM is the standard of care, how can they not cover it?
I’m interested in your experiences with Medicare and CGM, and how it’s billed. Thanks.

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They for sure cover Dexcom, unfortunately when Dexcom ended their provider status, you now have to go through 3rd parties. But if you do a quick search you will see the long and painful journey Dexcom and Medicare have gone through. I don’t think your pharmacy is correct, but they may not be one of the acceptable 3rd parties.

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I am on Medicare and have a Dexcom G6 that is covered. Medicare rules are testing 4 or more times per day and injecting insulin 3 or more times. I’m not sure how that affects pump users.

I am on a Medicare Advantage plan that requires me to go through a diabetic equipment supplier and not a pharmacy for supplies. I am not sure how just Medicare A and B work.

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Pharmacy should not give advice regarding Part B coverage!!!

Here is dexcom info on medicare.

[Dexcom G6 CGM for Medicare]

(Dexcom G6 CGM for Medicare)

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My Dexcom G6 is definitely covered by Medicare.

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Since recently going on Medicare (hey, not my choice to get “old” :laughing:) I’ve had my Dexcom scripts transferred about 5 different places and am still in search of a supplier. Osco, my general pharmacy, can’t bill Part B. Costco, where I got them before, not contracted with Dexcom under Medicare. Walgreens brick and mortar would work, but none located within 150 miles. :disappointed:
Now trying Advanced Diabetes Supply, has anyone heard of them? I’m interested in any experiences with them, please.

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Yes, I get my supplies from them and have been very satisfied overall. I can refill my supplies by email, which I really like. Also, ADS worked through the switch to Medicare without a problem. :smiley_cat:

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Sure beats the alternative!

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@CatLady Thanks, that’s good news!
@Chris I guess that’s good news too! :joy:

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@CatLady
Do you also get your test strips from Advanced Diabetes Supply? I was told that Medicare covers test strips under Part B as durable medical supplies. Is that your understanding? I was also told (by Advanced Diabetes Supply) that Medicare won’t cover Dexcom sensors and test strips at the same time, that Medicare assumes you need one or the other. Is that true??

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@Jan, I get the test strips under the pharmacy benefit from Express Scripts.

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@CatLady Do you have a Dexcom? From what I have understood before is that Medicare won’t cover test strips if you have a Dexcom covered by them. So I am curious!

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Yes, I do, covered now by Medicare while test strips have always been covered by pharmacy.

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@Catlady Thanks!

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