Medicare and Diabetes Supplies

Medicare Coverage for Diabetes Supplies

Question:  I have been on insulin pump for 4 years and will be on Medicare soon.  Does Medicare cover pump inserts and supplies including insulin?

Answer: Yes, Medicare covers the pump inserts and supplies as well as the insulin pump. This is covered under Medicare Part B, Durable Medical Equipment. You will be responsible for paying the Part B deductible which is $162 for 2011 then 20% of the cost of the supplies.  Medicare has a publication called "Medicare Coverage of Diabetes Supplies and Services". Click “Ask A Question” and request “Coverage of Diabetes Supplies” and I will e-mail you the publication. If you would like to have this in print, request that directly from Medicare-1-800-633-4227.

 A Medicare Supplement Plan F would pay the $162 deductible and 20% not paid by Medicare if you choose to enroll in a Supplement Plan. You are guaranteed issue for up to 6 months after your 65th birthday. After that you may not be eligible due to your diabetes. Please let me know if you would like a quote.

Medicare Part D

Part D Coverage Evidence

Question:  How do I know if I have prescription coverage?

Answer:  I am assuming you do not have employer sponsored health insurance and are Medicare eligible. In most cases you must enroll in either a Stand Alone Prescription Drug Plan (also known as a PDP) or you may receive prescription coverage if you are enrolled in an Advantage Plan that includes prescription coverage. If you qualify for extra help and failed to enroll in a plan when you were first eligible, Medicare will enroll you in one of their choosing. At the very least you will have an ID card for your coverage, either the PDP or the Advantage plan. If you have not been issued an ID card, it's likely you don't have prescription coverage.

Medicare, Tricare and Private Health Insurance

Medicare, Tricare and Private Health Insurance – OH MY!

Question: I have Blue Cross Blue Shield and Tricare. I turn 65 this October. I then must apply for Medicare or a replacement and Tricare for life. But one of the requirements to get Tricare for life is I must have Medicare Part B. My Blue Cross Blue Shield will at 65 go to my secondary insurance and Tricare for life will be third. I have two questions. What is best for me, Medicare or a Medicare replacement? If I choose a replacement for Medicare, do I pay the company of the replacement or the government? Also one more question. Can I apply for Medicare then get Medicare Part B from a replacement company?

Answer:  First, you need to be enrolled in Medicare Parts A and B and the only way to do this is through the federal government. Unless you are receiving Social Security Benefits, you will need to call Social Security (1-800-772-1213) to enroll in Part B. You may do this 3 months prior to your 65th birthday and I encourage you to do it sooner rather than later! (July for you) You should automatically be enrolled in Part A at age 65, but Social Security can confirm that for you when you enroll in Part B. Then you have the option of using your original Medicare Parts A and B as primary insurance and TRICARE for Life as secondary insurance (like a Medicare Supplement). TRICARE for Life will also cover your prescription drugs. When you refer to a replacement I am guessing you are talking about a Medicare Advantage plan where you assign your Medicare Parts A and B to the Advantage plan to manage and use their network. Unless you just really don't like TRICARE, there is no reason for you to do this. Tricare for Life will cover the deductibles and copays of Medicare. Unless your Blue Cross coverage is through an Employer paid group plan that costs you nothing, you don't need that either. It would be an unnecessary, added expense.


Medicare and Other Health Benefits: Your Guide to Who Pays First, a booklet available from The Centers for Medicare & Medicaid Services, may clear up some of this for you. I will be happy to e-mail you a copy of the booklet. Click the “Ask A Question” button and request “Who Pays First” Booklet.

Best Medicare Supplement

What is the BEST Medicare Supplement?

Question:  What is the BEST Medicare Supplement to purchase through which insurance or carrier?

Answer: The Federal Government regulates Medicare Supplement benefits. No matter which plan, A through N, no matter which insurance company, that particular plan's benefits do not vary. Any plan with one company has the same benefits as that plan with another company. Insurance companies may set their premiums so that is where the only real difference comes in with plans. Premiums are set by state and region so someone in North Texas will not pay the exact premium as someone is South Texas. Some companies offer discounts to their policy holders for things like Silver Sneakers Fitness or Vision discounts, etc. but these are not very significant and should be considered a nice addition but not a "deal breaker". Price is the only real difference in Medicare Supplement Plans.

Medicare Supplement Plan F offers the richest benefits, it is also the most expensive, but when compared to what the average 64 year old is paying for health insurance pre-Medicare, it's practically free! You can get a Plan F in Texas for between $110/month to $150/month depending on where you live.

There is no "Best Company" supported by documented fact! I work with all the major health insurance companies. I have a favorite based on my experience with their customer service both to me and on behalf of my clients. This is based on how quickly they pay claims, issue refunds; resolve problems, all those things that are important after the sale. Mutual of Omaha has customer service down to a T, it’s the best I get anywhere and exceeds everyone else. This is not to say I am not sometimes annoyed with them (and I will venture to bet the feeling is mutual about me sometimes!) There are other companies who do a good job but we're talking "BEST".

I know it's confusing and you get a TON of material on plans as you near age 65. My advice is to find an agent you trust. (I , of course, think that should be me but recognize you need to arrive at this conclusion yourself!!) Your agent should help you find the plan that is best for YOU based on your situation. Really, while indisputably Plan F is the best plan, it may not be what is best for you. You may not even need a supplement. Find someone who isn't trying to "SELL" you something but who is advising you and who will continue to advise you down the road after you make a decision on what is best for you.

I wish it was as cut and dried as saying "It's this plan from this company" . Please continue to ask questions as you need, I'm happy to help and hope I'm clearing some of the confusion.

Medicare Part D Prescription Drug Plan

Medicare Part D

This video was created in 2011. Dollar amounts cited have changed for 2012. Changes are:
Initial coverage stage increased to $2930
Coverage Gap increased to $4700
Maximum deductible increased to $320

First Medicare Beneficiary

On Facebook, Medicare Answers From Connie asked:  Who was the first Medicare beneficiary?

Tony Pallcaorolla - 0 people picked this one
Former President Harry Truman - 1 person picked this one
Ida May Fuller - 2 people picked this one

Former President Harry Truman was officially the first Medicare beneficiary. President Lyndon Johnson enrolled President Truman and presented him with the first Medicare card. Truman's wife Bess was the second person to enroll. Thank you for participating!

When did Medicare Start?

On Facebook, Medicare Answers From Connie asked:  When did Medicare Start?

July 1, 1966 - 7 people chose this one
April 30, 1942 - 2 people chose this one
In 1814, AFTER we took a little trip with Col. Jackson down the mighty Mississip - 0 people chose this one

July 1, 1966 is the correct answer! President Lyndon Johnson signed the Medicare Program in to law on July 30, 1965 and beneficiaries began receiving benefits the next year. Thank you for participating!