Medicare primary FEDERAL BLUE CROSS SECONDARY (FEP)

Healthcare & Insurance
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Anyone having luck getting a realistic reimbursement from FEP ?

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For Guardian Medtronic CGMS sensors.

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Hi Michael,
Medicare won’t cover my Freestyle Libre sensors or reader however Fed Blue Cross did. Hope this helps, Paul

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Thanks. I get my sensors from Medtronic in california but
having problem getting fep bobs to pay. Thanks. Sorry for the late reply back.

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For Medicare reimbursement, you must order through very specific mail order pharmacies and ONLY them. And you also must meet very specific Medicare guidelines. Otherwise Medicare will not pay for any of the cost of the Libre.

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Michael,
Medicare will not reimburse Medtronic sensors due to the fact that they do not meet the guidelines that they set up for manditory minimums…
…Last year, CMS announced coverage for therapeutic CGM for certain beneficiaries who have either Type 1 or Type 2 diabetes and intensively manage their insulin. To be included in this category, the device must be approved by the U.S. Food & Drug Administration (FDA) for use in place of a blood glucose monitor (BGM), enabling patients to make treatment decisions based on the information.
So to get approval for Medicare/CMS funding YOU must be able to make treatment decisions based off your CGM information. And Medtronic CGM is not smart enough to do that, and you still need to calibrate at least 3-4 times per day to keep it in “auto mode” (where as G5 is twice a day, and G6 and Libre is factory calibrated). Plus, Medtronic has not applied to CMS to be covered by Medicare/CMS for their sensor.

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