Has anyone on Medicare had a problem trying to get a prescription filled for more than 3 test strips/day. The prescription says “medically necessary” but Medicare denied coverage saying I need prior approval. I don’t know how to get that.
Has anyone else had this problem and how did you resolve it.
Any information will be helpful. Thank you.
Absolutely no problems at all getting 8 check strips per day with Medicare Marge @diabetes1. And I’m aware of other Medicare beneficiaries receiving greater number per day with zero out-of-pocket cost.
All it takes is for a properly qualified physician to write the prescription and be able to substantiate the need.
Thanks Dennis
Do you know how your doctor got the preapproval from Medicare. Did he call or write a letter?
Just writing it in the prescription is not enough. When the pharmacy submits in the system, payment is denied.
Hi Marge @diabetes1, the endocrinologist [she] wrote the prescription for [at least] “Eight [8] BG Checks per Day”. Nothing more; if the pharmacist or Medicare wants to make a change, permission nee to come from the prescribing physician.
The prior endocrinologist [he] I had been seeing also wrote the script in that manner - it is common practice among physicians; I have Medicare Beneficiary “friends” who are prescribed ten BG Checks per day. “Pre-approval” is not required.
There will need to be something in the doctor’s notes saying why he/she thinks you need to test more than 3 times per day. (I used to test 9 times per days, and my doctor wrote down the necessary tests, before and after each meal, before bed and first thing in the morning, in order to determine needed amounts of insulin required.)
Hello,
You have hit on one of my favorite raves! Nonerheless, it is a on going battle that I have fought for over 2 yrs. Nothing has changed, but it still remains, no matter how or what is put on my script, I still have to fight to get enough strips to calibrate my G5.
I kinda gave up and am switching to the G6. Reasoning that I will only have to do less sticks and with new system will go to 3 per day (test strips) available for use. Since I won’t be using that many, I’ll have all the test strips I need. Dear God I hope so!
But you may be just like me and have to be preapproved for the adequate number. To get them you have to start like 2 months before your script runs out and file all kinds of stuff to get it. I usually have the endo’s office do this. Less headache for me and they have all the info the ins co wants.Hope it helps, but it is an aggravating situation. Darned if you do and darned if you don’t. One option that helps is you can buy strips for certain meters at drugstores or Walmart. Not really cheap option, but if ya gotta have, you can get it!
Good luck!