I am not trying to stir the pot of frustration about Medicare and Dexcom … but here goes.
As I mentioned, Dexcom absolutely CANNOT sell me any product, for cash, because my file shows that I am covered by Medicare. Even if I just want to BUY a transmitter CASH, the answer is NO. They are referring everyone over to Liberty Medical Supplies in Port St. Lucie, FL, only open from 8am-5pm EST.
I finally was able to get to my desk early enough to call them today … and I sat on hold for 42 minutes. I finally reached a lovely rep named Liana (they’ve all been very pleasant).
Here’s today’s scoop:
- I first had to register as a new patient with Liberty … no problem, as, for some reason, I was already in their database?!
- Then they will request a new prescription from my endocrinologist … also no problem, even though there is one on file with Dexcom.
- Next, she emailed me the ABN (Advance Beneficiary Notice of Noncoverage) form. AHA, there’s where I learned a lot!
Medicare will cover orders as follows:
- Dexcom G5 Kit, a 90 day supply for $745.14, which may include
- 1 Transmitter
- 3 boxes of sensors
- 4 boxes of test strips, 2 meter batteries
- 1 blood glucose meter (brand unidentified), even if I don’t need one
- Dexcom G5 Receiver, for $277
After I submit this form, on which I choose whether I want them to bill Medicare, not to bill Medicare or not to order supplies, I can then call and place my order. Remember, today’s call lasted 62 minutes.
I was reminded that I would be fully responsible for $745.14 if I do not qualify under the Medicare criteria, which have not yet been published!
In other words, I will place an order, for things I do not need (because that is how Medicare is bundling it), without any assurance that I will meet the criteria for coverage and end up paying their cash price and filing another appeal with Medicare.
BUT, ordering parts I don’t need without a guarantee that it is even covered … just another major diabetes stressor!