Insulin is capped at $35 for at least one brand per insurance plan, by law. Whether they charge you that much is up to the drug part of your plan. And Jardiance and Januva are not capped. Each is about $500/month toward the donut hole. The first month each year eats up the deductible (around $500), then just for Jardiance - we hit the donut hole in September. But now that we've added Januvia to the mix we'll hit it in July (maybe earlier). It's gonna be an expensive year. I think she'll drop Jardiance. It is driving her nuts (constant yeast infections and a bladder that won't stop), but she just paid a bit over $500 for a 3-month prescription so she'll use that until her next check-up and if her A1C isn't too outrageous will probalby switch entirely to Januvia.
But back to the main quesiton - Diabetic supplies are covered by Medicare - but under part B, so they aren't included in the build to the donut hole. They are the standard 80/20 split for covered durable medical equipment (ours are covered 100% under out plan - but they could cost up to 20% under a different Medigap plan or MA plan).
It is the doctor I am mostly pissed at. It isn't the first time he's messed up on diabetic supplies - when I was first diagnosed we were on standard insurance. He said I could test if I wanted and gave me a meter with a few test strips then pointed me to Walmart. I don't expect him to know everything about every insurance plan, and knew enough about insurance to check in with them, so I didn't ever pay anything for diabetic supplies. But now that I'm on Medicare (which I do expect him to know more than the thousands of plans out there) - and after sending prescriptions for years to my DME provider - I do expect him to at least think about writing a prescription. If he had given my spouse a prescription, she would have brought it home to find the cheapest provider, rather than heading off to Walmart.
And Walmart - their policy is ridiculous, and on top of that, their refusal to file a claim with Medicare so we can get the coverage we are entitled to pisses me off.
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