Medicare Competitve Bidding Program
Notice for Medicare beneficiaries in the 9 Medicare Competitive Bidding Program areas who get diabetes testing supplies through mail order:
In December 2012, Medicare sent a letter to beneficiaries in the 9 Competitive Bidding Program areas who receive their diabetes testing supplies through mail order. The letter indicated that Medicare’s mail order contracts end on December 31, 2012. Be aware, you do not have to change your mail order supplier as a result of this letter. But you can use another Medicare supplier for diabetes testing supplies if you prefer. You may see your cost for testing supplies increase some as a result of this change. Please call 1-800-MEDICARE (1-800-633-4227) for more information and to find Medicare suppliers near you.
The Medicare Competitive Bidding Program began on January 1, 2011. Under this program, a limited number of mail order suppliers were selected to provide mail order diabetes supplies to beneficiaries in 9 areas of the country. The Medicare Competitive Bidding Program impacts people with Original Medicare (that is, not Medicare Advantage) residing in or visiting the following 9 areas of the U.S.:
- Charlotte-Gastonia-Concord (North Carolina and South Carolina)
- Cincinnati-Middletown (Ohio, Kentucky, and Indiana)
- Cleveland-Elyria-Mentor (Ohio)
- Dallas-Fort Worth-Arlington (Texas)
- Kansas City (Missouri and Kansas)
- Miami-Fort Lauderdale-Pompano Beach (Florida)
- Orlando-Kissimmee (Florida)
- Pittsburgh (Pennsylvania)
- Riverside-San Bernardino-Ontario (California)
To find out if your ZIP code is included in one of the 9 affected areas, call 1-800-MEDICARE (1-800-633-4227), or click here.
The mail order diabetes supplies included in the Medicare Competitive Bidding Program are: blood glucose test strips, lancets, lancet devices, batteries, and control solution.
If you buy your diabetes supplies through mail order and you live in or visit one of the 9 areas, you must use an approved mail order contract supplier in order for Medicare to help pay for the supplies. Please note that you may still purchase diabetes supplies at a local pharmacy or storefront and Medicare will help pay for them. The Competitive Bidding Program only applies to mail order diabetes supplies.
What will I pay for diabetes testing supplies?
For diabetes supplies, you are still required to meet your annual deductible. After you have paid your annual Part B deductible, Medicare pays 80% of the Medicare-approved amount for supplies and you are responsible for the 20% coinsurance. The coinsurance may be covered by supplemental insurance if you have such coverage. Please note, you may pay more for supplies obtained in a local store compared to mail order under the Competitive Bidding Program.
I live in a Competitive Bidding Program Area. What are my options?
If you purchase diabetes supplies from a local store, you can continue to obtain your supplies there.
If you wish to purchase your diabetes testing supplies from a mail order company, you must use one of the Medicare mail order contract suppliers.
- If your mail order supplier was selected, you may continue to use that supplier.
- If not and you want to continue to receive your supplies by mail, you will have to select a new mail order supplier. Suppliers approved under the Competitive Bidding Program may not regularly carry the product you are using now, but they may be able to arrange to provide it for you. Ask the mail order contract supplier if they will provide the testing supplies you want.
- If you switch suppliers, you might need to get a new prescription for your testing supplies or arrange to have your current prescription transferred.
- If a mail order supplier cannot provide the product you want, be aware that Medicare will cover the purchase of your supplies from a local pharmacy or storefront.
The Competitive Bidding Program does not require that you change your testing monitor. If you are satisfied with your current monitor, look for a mail-order contract supplier or a local store that can provide you with the supplies you need.
The program contains a protection to help beneficiaries get the specific supplies they need when medically required. Your doctor must prescribe the specific brand or type of supplies in writing and he/she must also document in your medical record that you need this specific item or supply to avoid an adverse medical outcome. Under these circumstances, a Medicare contract supplier is required to: furnish the exact brand or form of item you need; help you find another contract supplier that will furnish that brand or form; or work with your doctor to find an alternate brand or form for you.
For more information about the Medicare Competitive Bidding Program and to find contract mail order suppliers in your area, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare website.
Search for a list of mail order contract suppliers for diabetes supplies.
You can also contact your State Health Insurance Assistance Program (SHIP) for free health insurance counseling and assistance about Medicare. Call 1-800-MEDICARE (1-800-633-4227) to find the telephone number of the SHIP office closest to you. Find a list of SHIP programs.
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