Understanding Your Insurance Benefits for Diabetes Supplies

Article submitted by Marc Cohen, President of Diabetes Supply Center. For more information call 800-775-4372.

Have you ever tried to understand all the “fine print” in your insurance plan documents? How about all the talk about prescription benefits, medical benefits, replacement plans or supplemental plans? There's plenty to be confused about. When it comes to diabetes testing supplies, it's a good idea to take the extra time to fully understand your benefits. You may be able to save some money. Ask your local provider or pharmacy, or your mail order company if there are things you should know about your plan that can save you money and help you get the most from your benefits.

There are two items you may want to pay special attention to. First, your pharmacy plan (you might know this as your “Part D” plan) may have lower co-pays for certain “preferred” products. Why? Sometimes, insurance providers work with certain manufacturers to keep costs down for patients. Second, your out-of-pocket costs might be lower under your medical benefit. If you are a Medicare beneficiary, this falls under your Part B coverage. Based on the type of glucose meter you or your doctor prefers, your coverage may be better under your Part B plan. This holds true if you have purchased a Medicare “replacement” plan as well.

Not all insurance plans have these options, but it's always worth your time to ask. For example, if your plan allows glucose testing supplies to be covered as a medical benefit (as is the case with Medicare Part B), then these costs go toward your deductibles. In a pharmacy plan (i.e. a Part D plan), your co-payments likely do not count toward out of pocket maximums or other deductibles. In short, if you are spending $20 or $30 or $50 every visit to the pharmacy for diabetes supplies, these expenses probably don't “count” toward anything. On the other hand, some Part D plans offer very low co-pay amounts for certain brands of glucose testing supplies.

Yes, there is plenty to be confused about. So next time you fill your diabetes supply prescriptions, make a phone call or two and ask a few questions about the difference between medical and prescription benefits or about different brand options and how your costs might change. You just might be surprised!