Diabetes Supply Information

Medicare Part B covers the same type of blood sugar testing supplies for people with diabetes whether or not they use insulin. However, the amount of supplies that are covered varies.

If a member uses insulin, they may be able to get up to 100 test strips and lancets every month, and one lancet device every 6 months.

If the member does not use insulin, they may be able to get 100 test strips and lancets every 3 months, and one lancet device every 6 months.

If you document medical necessity, Medicare will allow additional test strips and lancets. "Medically necessary" means that services or supplies are needed for the diagnosis or treatment of the medical condition and meet accepted standards of medical practice. Physicians Health Choice will only cover blood sugar self-testing equipment and supplies with a doctor’s prescription. The prescription should include the following information:

• Whether your patient has diabetes
• What kind of blood sugar monitor your patient needs
• Whether your patient uses insulin
• How often your patient tests their blood sugar
• How many test strips and lancets your patient needs for 1 month

Supplies can be ordered and picked up at a network pharmacy or ordered from Byram Healthcare , to be delivered by mail.

Part B Diabetes Supplies Order Form

Remember:

• Members must ask for refills for supplies.
• A new prescription will need to be written for lancets and test strips every 12 months.

Physicians Health Choice won't pay for any supplies that were sent to the member automatically from suppliers, including blood sugar monitors, test strips, and lancets. If your members are getting supplies sent to them automatically, are getting advertisements that are misleading, or suspect fraud related to diabetes supplies, call our Fraud, Waste and Abuse hotline at 1-800-830-0817 (TTY 711).

Members that need assistance using their blood sugar monitor or ordering supplies may call our Disease Management Department at 1-877-287-0565 (TTY 711), 8:00 a.m. – 5:00 p.m., Central Time, Monday – Friday.

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