Medicare Limits on Test Strips

(Marge) #1

Has anyone on Medicare had a problem trying to get a prescription filled for more than 3 test strips/day. The prescription says “medically necessary” but Medicare denied coverage saying I need prior approval. I don’t know how to get that.

Has anyone else had this problem and how did you resolve it.

(Marge) #2

Any information will be helpful. Thank you.

(Dennis J. Dacey, pwD) #3

Absolutely no problems at all getting 8 check strips per day with Medicare Marge @diabetes1. And I’m aware of other Medicare beneficiaries receiving greater number per day with zero out-of-pocket cost.

All it takes is for a properly qualified physician to write the prescription and be able to substantiate the need.

(Marge) #4

Thanks Dennis

Do you know how your doctor got the preapproval from Medicare. Did he call or write a letter?

Just writing it in the prescription is not enough. When the pharmacy submits in the system, payment is denied.

(Dennis J. Dacey, pwD) #5

Hi Marge @diabetes1, the endocrinologist [she] wrote the prescription for [at least] “Eight [8] BG Checks per Day”. Nothing more; if the pharmacist or Medicare wants to make a change, permission nee to come from the prescribing physician.
The prior endocrinologist [he] I had been seeing also wrote the script in that manner - it is common practice among physicians; I have Medicare Beneficiary “friends” who are prescribed ten BG Checks per day. “Pre-approval” is not required.