Navigating Your Insurance Benefits for Diabetes Supplies

Have you ever tried to understand all the "fine print" in your insurance plan documents? How about all the talk about prescription benefits, medical benefits, replacement plans or supplemental plans? There's plenty to be confused about. When it comes to diabetes testing supplies, it's a good idea to take the extra time to fully understand your benefits. A little extra time just might save you some money. Ask your local provider, your mail order company or your pharmacy if they can help you save money and help you get the most from your benefits. Some insurance companies have specialists to help guide members through benefit alternatives, so a call to them may help too.

There are two items you may want to pay special attention to. First, your pharmacy plan may have lower co-pays for certain "preferred" products. Why? Sometimes, insurance providers work with certain manufacturers to help contain costs (both for you and your insurance company). Second, your out-of-pocket costs might be lower under your medical benefit. If you are a Medicare beneficiary, this "medical benefit" is your Part B coverage. Based on the type of glucose meter you or your doctor prefers, your coverage may be better under your Part B plan. This holds true if you have purchased a Medicare "replacement" plan as well.

Not all insurance plans have these options, but it's always worth your time to ask. For example, if your plan allows glucose testing supplies to be covered as a medical benefit (as is the case with Medicare Part B and many other plans), then out of pocket costs most likely count toward your deductibles. In a pharmacy plan, your co-payments likely don't count toward out of pocket maximums or other deductibles. In short, if you are spending $20, $30 or $50 on diabetes supplies on every visit to the pharmacy, not only do these expenses not help with deductibles, but they may be higher than medical benefit out of pocket costs.

Yes, there is plenty to be confused about. So next time you fill your diabetes supply prescriptions, make a phone call or two and ask questions about the difference between medical and prescription benefits or about different brand options and how your costs might change. You just might be surprised how much you can save!