Diabetes Self-Management Blog

As we noted in a recent post, Medicare spending is projected to grow enormously in coming years as the baby-boom generation ages and becomes eligible for the program. Major changes to Medicare may be necessary, including possibly replacing the current fee-for-service system with one in which health-care providers are paid for outcomes rather than for each procedure they perform. But several cost-saving changes are already under way, including the rollout of a new mail-order system for diabetes testing supplies (blood glucose meters and test strips) that was authorized by Congress back in 2003.

As noted last week in an article at Healthcare Finance News, starting on July 1, a nationwide mail-order system based on competitive bidding will go into effect. This means that instead of simply paying mail-order suppliers a set amount for each product, as it currently does, Medicare will solicit bids from mail-order suppliers and let only those with the lowest bids participate in the program. In exchange for offering lower prices, mail-order suppliers that participate in the program will get more business, and other mail-order suppliers will lose the business that Medicare currently offers them.

According to a fact sheet from Medicare, the new program is expected to slash the prices of mail-ordered diabetes testing supplies by 72%, with the savings shared between Medicare and participants in the program. However, as noted in a separate article last year at Healthcare Finance News, that number may turn out to be an illusion. According to Peter Cramton, an economics professor quoted in the article, a person who can no longer buy test strips from his preferred mail-order supplier may switch to a local pharmacy, in which case Medicare would end up paying about 260% more. And according to Andrea Bergman, a representative for a coalition of product manufacturers, pharmacies, and other groups that take issue with the new program, the bidding process may lead suppliers to narrow their offerings under the new program, possibly making certain types of test strips unavailable by mail order through Medicare.

What do you think — are you sold on the virtues of mail-ordering supplies or prescription drugs in the first place? If you currently receive your diabetes testing supplies by mail order, will you continue to do so after July 1 even if you must switch to a different supplier? Do you support efforts like these to save the Medicare program money, or are you concerned that delivery of mail-order supplies could be disrupted? Leave a comment below!

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Comments
  1. With testing supplies being temperature sensitive I worry what measures will be taken to reduce costs for a mail order company. Slower shipping times, longer periods on nontemp controlled trucks or stored in warehouses. Will the source cheaper supplies or ones close to expiration dates?

    I dont mail order because in summer months any delivery will sit on my porch in the direct sun all day. That is if the neighborhood kids dont make off with it first.

    Posted by Jenn |
  2. Effective July 1, 2013, the new single payment amount for a box of test strips under Medicare will be only $10.41 much less than the wholesale cost of the leading blood glucose test strip brands. This will be the amount for both mail-order AND retail pharmacy. What this means for diabetics on Medicare is that you will no longer have the option of receiving your preferred brand (or the brand your doctor wants you to use).

    Posted by Jon Johnson |
  3. I can’t think of any Govt. program that works as well as private companies and competition.
    This one will be no different!

    Posted by Amaze |
  4. I turned 65 today. Went to the pharmacy to get my strips but was told supplements do not cover durable medical supplies, so I will have to pay the 20% co-pay. I see ads on tv all the time about how they will ship your diabetic supplies at no cost to you and no shipping cost. That implies that they will bill Medicare directly. There are other ads for CPAP machines and adult diapers. I think these companies are taking advantage and that is one reason medical costs are so high. I plan on writing my congressman and having him look into this because the clerk at the pharmacy said they can not solicit directly. I also do not want mail order, especially for my insulin because of temperature variances. Turning 65 is a lot more complicated then it should be.

    Posted by Diane |
  5. At present I order my supplies through mail order. Because I have a supplemental insurance policy my 20% is paid for by them so I don’t pay anything for my supplies. I expect that with the government taking over July 1st. we will see big changes and they won’t be for our benefit. I also imagine the new health care will charge tax on all supplies. It is very depressing to see what is going on and anytime the government gets their fingers in something it’s never better. Coping with diabetes is enough to handle.

    Posted by Ferne |
  6. I have been receiving most of my meds via mail order for about eight years. I have never had a problem. This includes all of my diabetic supplies.

    Posted by Joan Forster |
  7. I think Diane’s pharmacy does not know how to file a claim for the supplement to pay her 20% co-pay. If they put it through as a drug, it won’t go. People on Medicare go through this over and over. But you would think this pharmacy could not get away with telling everyone on Medicare that their supplement would not cover the 20%. I have also dealt with pharmacies that would only accept Medicare for certain brands. I’m not sure if that is really legal, but they do it.

    Posted by BK CDE |
  8. To Diane, who doesn’t want her insulin delivered
    because of temperature variances. I am on insulin
    and I use mail order. My insulin is delivered
    in an insulated box with ice packs.
    Absolutely no problem!!

    Posted by Sandy Whelan |
  9. Same as Sandy, I get my insulin by mail and it comes in insulated box with ice packs.So did my strips last summer. Also, after delivery the ice packs were still cold as were the insulin . When the post office stops Saturday delivery they said they will still deliver packages and meds on Saturday.

    Posted by Chris Jolley |
  10. Properly done, and supported; mail order programs can be an effective way to save money.

    Unfortunately the wory about interference from outside well meaning interferences tends to ruin the programs.

    In the case of stripes, instead of offerering meter/strip choices that support all type 2 diabetes and body variances , somebody decides to take the cheapest worst case crap that has no resilience against interferors as documented and quietly hidden on FDA web pages but not in the released spec sheets to the unsuspecting. Good luck - that is all we support.

    Thats the disgrace. And I am fed up with that nonsense.

    Posted by jim snell |
  11. I recently was told to get my strips from a source other than my normal mail order pharmacy. This new source sent a kit containing a new meter which I did not need which speaks, in 4 languages,yet, (Spanish, English, French and Arabic; What about Polish and Dutch?) which would be fine if I was blind.
    The thing that irked me was the effort to sell me a back brace and or heating pad. “They are really nice and Medicare plus your insurance will pay for it.”
    No wonder we are in a financial crisis.

    Posted by Catherine Van Eck |
  12. I can’t really comment with any certainty until the program goes into effect, so I can see how it works. I worry a little about it, though, as I do with any measure that tries to cut medical costs.

    Posted by Roger Keith Ing |
  13. What next? Another step in making it more difficult for the elderly to say alive.

    Posted by lwp |
  14. I have had to help my mother with some mail-order programs and they have been a total ripoff. Just as Catherine mentioned, they sent a heating pad which according to the invoice was billed to medicare at the cost of $111!! We contacted the company and returned the items. This is the type of thing that is costing medicare a lot of money and should be dealt with. I also wondered about insulin being shipped since we will soon not be getting Saturday delivery by the post office and that is the carrier that was used by one of the suppliers my mother had.

    Posted by Glenda |
  15. If a person is using Medicare this is OUR U.S. government helping us. Medicare does need some review as there are always ways to carefully adjust without the use of drastic measures.

    Any change for supplies and the cost has been a concern for me as a Type 1 for almost 56 years; but I have managed through the changes just fine! - so far. Takes some research, though.

    I can not use any mail order delivery for insulin. My system is too sensitive to insulin not kept at 47 - 49 degrees F.

    I also live in a Tsunami, earthquake zone! Didn’t know this 22 years ago! I have extra supplies stored that goes with me wherever I am.

    As for what will occur with the changes to Medicare? I will wait to see before deciding what to do.

    Posted by joan |
  16. Say what you will, I’ll never use mailorder for drugs and medical supplies again. First they shipped the wrong medicine, Then they shipped test strips that were 2 years out of date. Then they shipped me a sulpha drug, (I am allergic to sulpha drugs)! Then they had the gall to demand that I pay them for that garbage. Never again.
    With a government run program, things can only get worse.

    Posted by Karl |
  17. I have been getting my diabetes supplies through mail order and have been satisfied with it. I’m on an insulin pump and get my pump supplies and testing strips through mail order also. My fear is that with a government takeover, they will not cover my insulin pump brand and supplies. I get my diabetic supplies with a three month supply.

    Posted by Patricia Thomas |
  18. Here in Southeast Iowa my doctors office told me in late January that all diabetics getting supplies paid by Medicare would have to use a given brand of meter and testing supplies. No explanation. I had just gotten a new meter of a different brand and liked having the lancet, supply of test strips, and meter all in one unit. The new brand has separate lancets, meter, and test strips, so there are three things to juggle and you have to insert a new test strip each time. But this brand includes a little case to hold all three items. Its a bit more of a hassle but I adapted. But still no explanation to me or, as far as I know, to my doctor or pharmacist why the change was made.

    Posted by Keith |
  19. I have type 2 diabetes and use strips and lancets to monitor my blood sugar. Just last week the company that provides my supplies informed me that they will no longer be able to provide the supplies for my meter and sent me a new meter from a company I’ve never heard of and the strips and lancets to go with it. I just received this stuff yesterday and have not tried it, so I can’t comment. However, the meter I’ve been using for years is fine, but I guess the supplies are more expensive. I told the provider that I regarded the situation of forcing a new meter on me as coercion and that I would take my business elsewhere. However, based on the comments from others, I guess there is no elsewhere if all of the providers are trying to out do each other with low bids, we’ll be lucky to get anything at all.

    Posted by Lynne Nelson |
  20. I am worried about this change. I have a supplier, Liberty, and have had no problems with this supplier. I am worried that this will disrupt the flow of the strips needed to check my blood sugar. I would be out a lot of money if this should happen and if I had to buy strips elsewhere.

    Or what if the ones who win the supply orders, are not good quality strips?? Just sayin

    Posted by Cherry alexander |
  21. I have been getting my diabetic supplies from Liberty, but Humana no longer pays them for diabetic supplies. My next order will go to Right Source which is Humana’s supplier for drugs and now diabetic supplies. I have no problem with mail order for these supplies, and I’m glad that there is an attempt to hold the costs down for diabetic supplies. Since I’m retired I always get the mail soon after it arrives. So the supplies will not be setting out in the sun.

    Posted by Carol Gable |
  22. As an employee of one of those mail order pharmacies. I can say with 100% confidence that this is gonna be bad.I receive calls everyday from patients wanting to know why a necessary medicine isn’t covered, or worse covered but the copay is so high they can’t afford it. Many people don’t have a clear understanding of their medicare insurance, or of the supplemental. I advise everyone to speak to other seniors, or senior agencies that can better help them understand what is offered with each supplemental plan. Mail order can save money - if they ship the medication on time and they fill the prescription correctly. Many patients are losing the option of meter type and strips. The insurance is limiting the brand they will cover, some refusing to cover these supplies at all. When asking a customer service person for a price. Ask what meter is covered. If the meter isn’t covered - what strips are covered? What are the prices? Often one meter will cost a few dollars more, however, the copay on the strips will more than make up the difference. Don’t be afraid to ask? It’s your money!

    Posted by Kelly |
  23. I have already tried the mail order to “the low bidder” I was unable to find any that offered brand name products such as I currently use. Previous to the Kansas City area mandatory bid program, I got my strips through my “preferred mail order provider” with no problems. Now I have to drive several miles to a WalMart Pharmacy to get the strips that the Dr prescribed and I prefer. The bid program will - if like the KC program - result in no name products being the only product available.

    Posted by William Flanigan |
  24. I will not use mail order again . I ordered my oxycoten by a big co and when recieved i got my other perscriptions which each one was in 3 bottles when it came to my oxycoten I got 1 small and 1 large container when used small one and got to large one i opened it and found about 2 ft of cotton in it and 484 pills short i called them and asked how they can get 2 feet of cotton and 484 pills in bottle aftr talk with dr i had to get repleaced it But first thing i did do was call DEA,Postal Inspector and FBI and for sure no one would call all them and report it first and that was the end of Mail order.I called Senator and told them to pass a bill that All bottles are sealed before leaving where filled and gone to shipping

    Posted by Louis P. Sznkovics |
  25. Liberty is out of business.

    Posted by Jamie |
  26. I should say Liberty is out of the diabetic testing supply business.

    http://www.wptv.com/dpp/news/region_st_lucie_county/port_st_lucie/liberty-medical-bankruptcy-port-st-lucies-liberty-medical-supply-inc-files-chapter-11-bankruptcy

    Posted by Jamie |
  27. Jamie:

    Thanks for sharing that data.

    I had to move away from these guys.

    Posted by jim snell |
  28. Jamie:

    On Diabetesforum I see the following today:

    Liberty Medical
    Just to let you all know Liberty Medical has transferred all it’s Diabetic Test Supplies operation to Ariva Medical.

    Posted by jim snell |
  29. Last year my mail order supplier stoppedsupplying insulin and insulin pump supplies. I changed to another popular supplier and now about six weeks ago they informed me they were no longer supplying insulin to medicare diabetic clients. Last week I called in my new 3 month supply for my blood glucose testing supplies and was told (no advance notice) that they no longer supplied testing supplies to medicare clients. I have an insulin pump that my blood sugar monitor communicates with. I spent hours on the internet searching for a medical supplier that supplied testing supplies for my current blood sugar monitor (which communicates with my insulin pump). I am working with a company in California attempting to set this up. awaiting for paper work to go through. I have had insulin dependent diabetes 50 years this year and have to test my blood sugar TEN times a day and during the night. Medicare will pay for insulin under part B if the client is on an insulin pump. They are telling me that due to changes in medicare reembursement policies they can no longer supply the insulin or the testing suppliees I need to keep descent control of my diabetes. What in the world is Washinton thinking. they are killing me with these changes. The company I was using did a financial assessment on me and waived the 20% co-pay for medicare. I still have to find a local pharmacy to get my insulin from under medicare part B. But I will have to come up with the money to pay the 20% medicare copay. which will cause a hardship on my disability social security income. What has Obama done?

    Posted by art |
  30. Just found out this morning that Liberty Medical had transferred its Diabetic Testing Supplies operation. It would have been thoughtful if they had notified me. I ordered my supplies from them about two weeks ago and was not told. Today, I learn that the new company will have to contact my doctor (who is out of the offce for a week) and then it would be 7-10 days. Not really happy today!

    Posted by Catherine |
  31. I turned 65 in Feb. and don’t use mail order for my strips and meds. Since the problems with Liberty I was a little skiddish of mail order. Can anyone suggest a good mail order supplier and fill me in on how this new law will work. Thanks.

    Posted by Angela |
  32. I cannot find a mail order pharmacy for insulin used in a pump. Optum no longer provides this service. Most local pharmacies can’t or won’t submit a part b claim. Help!!

    Posted by betty peterson |
  33. I have used a mail order program for several years because my cost share locally is so high I cannot pay it.I am diabetic and like all it may mean life or death if I Don’t get my meds and supplies. Well I wish they would outlaw mail order all together. It has been one fight after another. Right now I am fighting them because they shorted me 2 boxes of insulin. I never had these problems when I could go go to local drug store and pick every thing up. What makes things worse I can’t even switch to another mail order place. My insurance will not pay if I do.So my advice to all if u can avoid mail order do IT IS NOT ONLY DANGEROUS IT CAN BE DEADLY! I still don,’t know what I am going do do to make my insulin last until my next refill. I have called and spent hours on the phone and they say they can fill it anyway they want and as for me take it or leave it. By the way the pharmacy is one contracted by our wonderful We hope you die government. We the people need to fight to get Obamacare refunded or it will only get worse.

    Posted by Ann |

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Flashpoints
Uncoordinated Care (04/23/14)
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The Costs of Innovation (04/09/14)
Diabetes to Go (04/02/14)

 

 

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