The Balanced Budget Act, passed by Congress in 1997, provides coverage for diabetic services, which reduces many of the out-of-pocket expenses for diabetics.
Effective January 1, 1998, some Medicare diabetic supplies were covered for Type I and Type II diabetics, whether or not the person was using insulin.
To be eligible for benefits, the individual needs:
*a prescription from their physician on
file with their pharmacy
*to meet the annual Medicare Part B
deductible, which is usually $100
The pharmacy can file a claim for the individual and, if the pharmacy accepts the assignment, Medicare will pay the pharmacy for the diabetic supplies. These supplies can include:
* blood glucose monitor
* testing strips
* lancet devices
* control solution to check that your
glucose meter is working properly
If the pharmacy does not accept the assignment, the individual will need to pay the pharmacy, and then submit a copy of the receipt along with the Medicare claim form, to the Medicare Government Benefits Office, to receive a check for 80% of the approved amount, for their Medicare-approved diabetic supplies.
If the individual has a Medicare supplement, their 20% responsibility may also be covered.
The most important thing is to be informed about how the Balanced Budget Act effects you. Contact your local Medicare office, or talk to your pharmacy about how you can take advantage of the Act to ease the costs associated with diabetes.
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