Retiree Health SPD

Benefits are provided for an approved diabetic training program prescribed by a physician, including education, training, meal planning (although not the cost of meals), and treatment and prevention of hyperglycemia or hypoglycemia. Coverage is also provided for diabetic supplies including insulin, syringes, blood glucose testing strips, lancets, and a home blood glucose monitor when prescribed by a physician.

Helpful Hint

If you are diabetic, the following guidelines may be helpful to you when purchasing diabetic supplies (non-Medicare individuals only):

You may purchase insulin, syringes, blood glucose testing strips, and lancets through either of the two prescription drug programs – the Medco Health Retail Pharmacy Program or the Medco Health Home Delivery Pharmacy Service.
If your physician prescribes a home blood glucose monitor, you may purchase the monitor from the pharmacist and submit the pharmacy receipt with the completed claim form to the Trust Office. Home blood glucose monitors cannot be processed through either of the two prescription drug programs.

Medicare Note

If you are diabetic, the following guidelines may be helpful when purchasing diabetic supplies:

Medicare covers a home blood glucose monitor, blood glucose testing strips, lancets, and other diabetic supplies used with the monitor, whether or not you use insulin. Medicare does not pay for insulin, syringes or anything used to inject the insulin such as needles, alcohol, Betadine, or cotton balls. However, the Retired Plan covers insulin, syringes and needles through either of the two prescription drug programs.

For Medicare to pay for covered diabetic supplies, you should follow these steps:

See a physician and get a prescription for the supplies needed. The prescription must include: a diagnosis of diabetes, the number of blood glucose testing strips, how often your blood needs to be tested, and if you are being treated with insulin. Medicare will not honor a prescription for blood glucose testing strips that merely states “as needed.”
Take the prescription to a store, pharmacy or supplier which is authorized to bill Medicare. Before ordering from a supplier, ask if they will bill Medicare. To bill Medicare, the supplier, store or pharmacy must have a Medicare supplier number (or Medicare billing number). This number is used on all Medicare claims for supplies used at home. It is a ten-digit number usually ending in 0001. Without this number, the supplier cannot bill Medicare. You must purchase the supplies and then send the claim to Medicare.
Your physician must renew the prescription every six months. Medicare will not continue to pay for supplies unless the prescription is renewed. You must tell the supplier how many supplies are needed each month.
When Medicare processes these charges, submit the Medicare Summary Notice and the itemized receipt to the Trust Office.

Diabetic Care – 90%