Does Medicare Pay For Diabetic Test Strips?

Does Medicare Pay For Diabetic Test Strips?

Yes, Medicare will pay for diabetic blood glucose test strips. In fact, Medicare will pay for all Part D prescription medications, including diabetic test strips.

However, Medicare will only pay for diabetic test strips if they are acquired through a retail pharmacy (such as Walmart or CVS). Medicare will not pay for diabetic test strips that are acquired through a mail-order pharmacy, such as those that are found at Costco, Sam's Club, or Target.

Medicare Part D will also not pay for diabetic test strips that are dispensed as a supply that is less than a 30-day supply. In addition, Medicare will not pay for diabetic test strips that are part of a 90-day prescription.

However, since Medicare Part D will only pay for diabetic test strips if they are acquired through a retail pharmacy, and not through a mail-order pharmacy, it is possible to get around Medicare's rules.

That's because Medicare rules state that diabetic test strips can be acquired through a mail-order pharmacy if they are received by the end of the payer's prescription coverage period.

In other words, if you have a prescription of diabetic test strips that is 30 days long, but you acquire the test strips through a mail-order pharmacy, Medicare will not pay for the test strips.

However, if you have a prescription of 90 days' worth of diabetic test strips, and you acquire the test strips through a mail-order pharmacy, Medicare will pay for those test strips.

In other words, you will have to receive the 90-day prescription in less than 90 days to get Medicare to pay for the diabetic test strips which are part of the prescription.

In addition, the diabetic test strips you receive from the mail-order pharmacy must be received by the end of the 90-day prescription coverage period (meaning, you have to receive the 90-day prescription within 90 days or earlier).

Even if you do get Medicare to pay for your diabetic test strips, they will be paid as a 90-day supply, which will significantly increase your out-of-pocket expenses.

And while Medicare will pay for diabetic test strips, there are a few other rules that come into play.

For instance, Medicare will not pay for diabetic test strips if:

You received or will receive your diabetic test strips as a sample from a physician, pharmacist, or other provider.

You are enrolled in a Medicare Advantage Plan (like a Medicare Part C Plan).

You are enrolled in a Medicare Cost Plan.

You are enrolled in a Medicare Prescription Drug Plan and do not use a Medicare Advantage Plan to cover your Part D prescription drug coverage.

You are enrolled in a Medicare Select Plan that does not cover diabetic test strips.

How much do diabetic test strips cost?

Medicare will pay for diabetic test strips as a 90-day supply, which means that your out-of-pocket expenses will be significantly higher than if Medicare paid for the test strips as a 30-day supply.

Your out-of-pocket expenses for diabetic test strips will be the cost of the test strips, including the cost of the retail pharmacy, plus the administrative costs, plus the cost of the mail-order pharmacy, plus the cost of the prescription.

For instance, if the diabetic test strips cost $40 at the retail pharmacy, $10 at the administrative office, $10 at the mail-order pharmacy, and $5 for the prescription, your out-of-pocket expenses will be $65.

On the other hand, if Medicare paid for the test strips as a 30-day supply that cost $40, your out-of-pocket expenses would be $10.

What are the costs of diabetic test strips?

Medicare will pay for diabetic test strips as a 90-day supply. This means that you will have to pay the cost of the test strips, including the cost of the retail pharmacy, plus the administrative costs, plus the cost of the mail-order pharmacy, plus the cost of the prescription.

What Medicare does not pay for diabetic test strips?

Medicare Part D does not pay for diabetic test strips that are acquired through a mail-order pharmacy. This includes any pharmacy that offers free shipping, such as Target, Sam's Club, or Costco.

Medicare Part D does not pay for diabetic test strips that are part of a 90-day prescription.

Medicare Part D does not pay for diabetic test strips that are dispensed as a supply that is less than a 30-day supply.

Medicare Part D does not pay for diabetic test strips that are acquired through a retail pharmacy if you are not enrolled in a prescription drug plan.

Medicare Part D does not pay for diabetic test strips if you are enrolled in a Medicare Advantage Plan.

Medicare Part D does not pay for diabetic test strips if you are enrolled in a Medicare Cost Plan.

Medicare Part D does not pay for diabetic test strips if you are enrolled in a Medicare Prescription Drug Plan and do not use a Medicare Advantage Plan to cover your Part D prescription drug coverage.

Medicare Part D does not pay for diabetic test strips if you are enrolled in a Medicare Select Plan that does not cover diabetic test strips.

So is Medicare supposed to pay for diabetic test strips?

Medicare is supposed to pay for diabetic test strips, but it won't pay for them unless they are acquired through a retail pharmacy.

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