This post is for the 65 year or older type 1’s who have Medicare and pharmacy coverage.
It is my understanding that Medicare part B covers the Dexcom G6 supplies (and other brand CGM’s) but not insulin pens. Only part D does.
Can someone give me a ballpark figure on how much part D monthly premium is? I cannot get any “quotes” from the government until I am older (I am approaching 61 y/o).
As far as supplemental health, I am open to taking specific recommendations or sites where I can find some choices. Currently, just the diabetes, no other health issues.
Good idea to start doing research now. I’ve got a few years to go myself and was startled when I started getting mailings about Medicare coverage but I should start familiarizing myself so I’m not totally overwhelmed when the time comes. Things may be different but at least I’ll have an idea. Thanks for that much in the tail - I needed that!
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Good to see you back Cathy @HopeFloats2020 .
It stands to reason that today’s prices and costs will not be in effect when you reach 65; they may be either higher or lower. I do not use Part D, but rather chose Part C which includes both Parts B & D benefits plus many other coverages and the monthly premiums differ with each plan and carrier. After full analysis [which I’m reviewing now for my 12th year of Medicare coverage - I used an employer plan until I retired at 70], I’ve chosen the Medicare Advantage Plan [called Part C] with the highest monthly premium [$148 / mo.] because it provides me with the lowest overall cost when all my medical care prices are added together.
There is a section about insurance on the main JDRF webpage [jdrf.org]; a link to the Medicare information is below. This JDRF guide is complete with general price tags; keep in mind that prices/costs/availability of plans is different from region to region - except for the maximum monthly premium that I have - the max is controlled by government regulation. A way for you to see what is available to you, with prices in YOUR region is to “age yourself by four years” and go on to medicare.gov - there you will see a choice of plans and carriers.
The JDRF link: Medicare and Type 1 Diabetes - JDRF
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Oh you can find exact prices easy. There is a choice to look at quotes without signing in and you can even put in a year for your Birthday that is 65+. You gotta play with it. Dont be afraid. Part D is anywhere from $20-$30 on average but it varies widely by zipcode. Find a Medicare plan and choose “Continue without logging in.”
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Something else that most people don’t know: Medicare A, B, and C are automatically approved when you apply for them, the insurance companies can’t refuse you.
Part D differs in 1 important way, it’s a more traditional insurance plan that is allowed to take a profit if possible. Diabetes is considered as making it impossible. If you apply for it with ANY insurance com,pany it wil;l be refused immediately.
Thing to do is to sign up for a Medicare Advantage plan, which will pay for what you need with certain set copay amounts for whatever you need to order. This can be researched at Medicare.gov at any time.
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Hi Cathy,
It’s Medicare open enrollment season from now until early to mid December, so the internet and the television are plastered with information on Medicare Part D. You will find that the plans vary with where you live and with what the plans do to balance monthly premium and deductible. For example, a single insurer may have a plan as low as $ 12/month premium (but something like $ 500 annual deductible) and also have a plan with $ 70 / month premium, but no deductible. So a person has to strategize, depending on what medicines they take or think they will take. Then there are pages of confusion verbiage on “tiers”.
I don’t want to include any company names in this post, but if you search on Part D and any of the insurer names that you have heard of or seen in the newspaper or TV, you will be able to turn up websites for their plans, start plugging in your zip code and any medications, and will be able to estimate costs, at least for 2021 and 2022.
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You might try Sanofi for you insulin pen needs. I get all my vials from them & it’s free. Hope this helps.
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Hi @Dennis!
Thanks so much for this wealth of info! Appreciate it, as always.
@808IUFan Thanks, Larry!
@tedquick Thank you!
@RMcM Thanks so much!
@sherlock2667 Thanks, Ron!
You’re very welcome HopeFloats2020. Have a great day.
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That isn‘t true. I‘ve been on traditional Medicare for 3 years and no trouble finding and signing up for a drug plan (part D).
hi @Rbmandelbaum … it would be nice if you just explained your experience with Part D, why it’s good for you and and how it helps you. just a thought to help this conversation.
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There isn’t much to tell. I decided to go with traditional Medicare, which for most people means selecting a drug plan (part D) and also a Medicare Supplement plan (often called a Medigap plan) to cover the 20% of part B costs that Medicare doesn’t cover. To choose a drug plan, I used the Medicare-supplied tool that allows you to enter all your prescription drugs and comes back with a list of plans that cover your meds and the approximate yearly cost. You then choose the one that fits you best. Also, many communities offer counselors through a program called SHINE to help you choose the appropriate plan.
If you go with a Medicare Advantage plan, rather than traditional Medicare, all your benefits, including drugs, are wrapped up in an all-inclusive package. This can be advantageous and can cost less. Keep in mind that:
- If you switch to a Medicare Advantage plan from traditional Medicare with a Medigap policy and then want to switch back, you may not automatically be accepted by the Medigap plan you originally had. There’s a time limit – I forget the exact value – might be a year.
- With Medicare Advantage plans you are often limited to the network of providers within that plan. Traditional Medicare allows you to see any provider, without referrals, in the country who accepts Medicare.
One interesting note: Medicare part B does not normally cover insulin. Your part D (drug plan) covers it, and the cost is based on the plan, the type of insulin, and the delivery system. However, if you are a pump user, Part B covers the insulin together with all the pump supplies as part of Durable Medical Equipment.
Hope this helps!
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I disagree 100%!! A Medicare Supplement is much better for a diabetic. After the yearly $233 deductible you will pay ZERO. This includes pump, supplies, insulin, test strips, everything. Sure you pay more a month, but in the end, you pay much less. Medicare Advantage plans are a scam.