I wrote a post titled “Medicare and CGM Coverage: Love Your Receiver!” and explained how Medicare justified the approval of the G5 as Durable Medical Equipment (DME) because
Deadline Nears for Decision on Medicare CGM CoverageMary K. Caffrey
CG modifier must be added to the claim, only if all of the CGM coverage criteria in the Glucose Monitor LCD are met CGMs (K0554 and E2102) and related supplies (A4238 and K0553) which are classified by the Food & Drug Administration as Class III devices must include the KF modifier....
If a CGM falls under part B coverage but you get it at the pharmacy, can you use goodRX in conjunction with the insurance? Reply Jagger Esch says: May 2, 2022 at 7:36 am Melinda, You are never able to use insurance coverage and GoodRx. In this case, you would need to see whic...
The training sessions include an overview of the Rx coverage and information resources; the enrollment process and resource kit; how to use the online Prescription Drug Plan Finder tool; and two open Ask the Experts Q&A sessions. Web tool estimates Medicare Rx costsCMS has posted a Web tool ...
$0 monthly premium $0 deductible no gap in coverage no gap in coverage $1 co-pay for generics; $3 co-pay for name brands must be Medicaid- eligible $0 monthly premium $0 deductible no gap in coverage $2 co-pay for generics; $5 co-pa...
That sounds very straight forward but I worry that it is not. The elephant in the room for those of us on G5 isThe Receiver. In January 2017 after the initial approval of the Dexcom G5 by Medicare, I wrote a post titled “Medicare and CGM Coverage: Love Your Receiver!” and explaine...
The study found the following: fewer patients entered the coverage gap in 2007 with 15.5% entering versus 17.1% in 2006; patients are willing to stay on their branded medication while in the coverage gap for the first 60 to 90 days. However, with the average stay in the gap increasing to...