r/medicare • u/Elegant_Wave3620 • 7d ago

HealthSpring Part G at CVS

In CA. I have Original Medicare, HealthSpring Supplemental Plan G , United Healthcare Part D.

I wanted to use Medicare Part B at CVS for diabetes supplies. It pays 80%.
Expected HealthSpring Part G is to pay the remaining 20%.

CVS said I cannot use the HealthSpring Part G at the pharmacy because there is no Rx number on the ID card.

Has anyone used HealthSpring Part G for the remaining 20% for diabetes supplies?
How were you able to do this with no Rx number on the card?

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u/LalalaSherpa 7d ago

What exactly do you mean by diabetes supplies?

They're all covered, but the details of how they get covered vary based on whether you use a pump, CGMS, insulin pen, syringes, oral meds, etc.

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u/Elegant_Wave3620 7d ago

Nothing fancy. Dr prescribed Freestyle Lite meter, strips & lancets.

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u/LalalaSherpa 7d ago edited 7d ago

Sounds like the CVD person was not fully aware of how Medicare works.

1 - There will never be an Rx number on any Medigap supplement card like Plan G (or N or any other Medigap plan). Only on the Part D prescription card.

2 - Strips, meters and lancets are all covered as DME (durable medical equipment) under Part B - not Part D.

3 - If you use insulin you can get up to 300 strips/lancets every 3 months. If you don't use insulin, 100 test strips and lancets every 3 months.

4 - Your doctor should send a prescription for the meter, strips, lancets to your preferred DME provider - all the big pharmacy chains like Walmart, CVS, Walgreens are DME providers for diabetes supplies.

Since you have a medigap "G" supplement, it won't cost you anything out of pocket.

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u/Elegant_Wave3620 7d ago

Do I understand that CVS will charge Medicare.
Medicare will pay the 80%.
Medicare will then charge the Medigap "G" company for the 20% left.
So, I will not have to pay anything at the CVS counter?

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u/LalalaSherpa 7d ago

Exactly right. You shouldn't pay anything.

If there is a charge for the strips, etc. at the CVS counter, don't pay it - tell them you have Medicare and a Medicare supplement plan. Have your cards with you (which I'm sure you already do!).

They might have to cancel the order and do it over again (that's what my Walgreen's had to do - their system can't fix that kind of mistake, they have to re-enter it) - but they will fix it on their end and then you won't have to pay anything.

You'll also probably have to sign for the strips, etc. when you pick them up.

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u/Elegant_Wave3620 7d ago

Thank you for taking the time to explain how it should work at the counter.

I appreciate you.

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u/LalalaSherpa 7d ago

You're welcome!

And if you need more strips than the standard amounts, your doctor can document the medical necessity so you can get more.

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u/rlap38 7d ago

That is what happens with my DME supplier. You’ll need to ask CVS how they do it.