Continuous Glucose Monitoring Devices
Aetna considers the short-term diagnostic use of continuous glucose monitoring devices medically necessary for persons with diabetes who have either of the following problems in controlling blood glucose level, unresponsive to conventional insulin dose adjustment:
Aetna considers the short-term diagnostic use of continuous glucose monitoring devices medically necessary to diagnose primary islet cell hypertrophy or persistent hyperinsulinemic hypoglycemia of infancy in persons with symptoms suggestive of recurrent hypoglycemia.For short-term diagnostic use, no more than 2 continuous glucose monitoring periods are considered medically necessary within a 12-month period.
Aetna considers experimental and investigational the long-term use of continuous glucose monitors for individuals with type 1a glycogen storage disease, persons with type 2 diabetes not using intensive insulin regimens, nesidioblastosis , neonatal hypoglycemia, and for monitoring blood glucose in non-diabetic persons following gastric bypass surgery because there is insufficient evidence of the clinical benefits of this approach for these indications.
Diabetic Supplies: Therapeutic Shoes And Inserts
Medicare Part B coverage includes therapeutic shoes or inserts for diabetics who have certain conditions ask the doctor who treats your diabetes if you need them. To make sure these supplies are covered by Medicare, please note:
- A qualified doctor must prescribe the shoes or inserts.
- A qualified doctor must provide and fit you for the shoes or inserts.
- Medicare Part B covers one pair of custom-molded shoes or one pair of depth-inlay shoes per calendar year.
- Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for depth-inlay shoes.
- In certain cases, shoe modifications may be substituted for inserts.
- The supplier must have an order on file signed and dated by the treating doctor if you switch to a different supplier, you may need to have your prescription transferred or get a new prescription from your doctor. Make sure your supplier is enrolled in Medicare.
How Does Medicare Advantage Cover Diabetes
If you have Medicare Advantage, your plan must give you at least the same coverage as Parts A, B and D but there may be different rules. You may have different rights, protections and choices for where to get your care. You may even get extra benefits. For more information on coverage, read your plan materials or contact your plan for information.
There are also Medicare Special Needs plans ,6 which are a type of Medicare Advantage plan that limits membership to people with a specific disease, such as diabetes. Medicare SNPs design their benefits, provider choices, and drug formularies to meet the needs of the group they serve.
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What Health Plans Does Medicare Offer
Medicare has four parts:
- Part A, or hospital insurance, covers hospital stays, skilled nursing homes, hospice care, and some home health care. Part A has no premium for those who have paid enough Medicare taxes. Part A has a deductible, which is an amount you pay for your care each year before the plan begins to pay.
- Part B, or medical insurance, covers doctor visits, outpatient care, some home health care, medical equipment including insulin pumps, and some preventive services. You pay a monthly premium based on your income. After you pay the deductible each year, Part B pays 80 percent for most covered services, and you pay 20 percent.
- Part B covers the Medicare Diabetes Prevention Program for members with prediabetes. The MDPP provides healthy eating and physical activity training sessions and support over 12 months, which research shows can sharply lower diabetes risk.
Best For Orthopedic Supplies: Allegro Medical
Allegro Medical
Why We Chose It: Allegro Medical sells nearly 1,400 orthopedic-specific supplies and has a rating system to help consumers choose the best products.
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More than 1,400 orthopedic supplies from trusted brands
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Customer ratings help guide purchase decisions
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Can shop products by injury type
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Insurance not accepted
Although Allegro Medical sells several categories of medical supplies, we were most impressed with its orthopedic and orthotic options, which number nearly 1,400 different products. Categories in this section include shoes, foot/ankle, hand/wrist, neck/shoulder supports, splints and splinting accessories, traction, positioning aids, and more. You can also shop by condition/injury, which aids in the purchasing process. Allegro Medical has buyers guides that can help you learn more about deciding which items to purchase.
We especially liked that the company lists customer ratings on its website from one to five stars. Because there are so many different orthopedic supplies available, the rating system makes it easier to evaluate the best products. Some of the pricing includes $52 for an offloading post-operative shoe, $1 and up for elastic compression bandages, and $72 for a hinged knee brace. The company also offers free shipping on orders that exceed $99. Auto-ship options are available.
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How Does Medicare Part D Cover Diabetes
Medicare Part D is prescription drug coverage. If you joined a Medicare drug plan, youre covered for the following:5
- Insulin: This includes injectable insulin not used with an insulin infusion pump and inhaled insulin.
- Anti-diabetic drugs: Medicare drug plans can cover anti-diabetic drugs to help blood sugar when not controlled by other measures.
- Diabetes supplies: The supplies you use when you inject or inhale insulin may be covered, including syringes, needles, alcohol swabs, gauze and inhaled insulin devices.
What Can I Do If I Cant Afford My Insulin
The cost of insulin can be a big concern for people with diabetes. Thankfully, there are resources available for people struggling to afford this medication.
If you need a short-term solution or its an emergency, contact your doctor first. Many health care providers have insulin samples that they can provide to beneficiaries. Free clinics are another source of samples in an emergency.
The diabetes community also bands together to help people with an urgent need by donating extra medication. Searching for diabetes pay-it-forward programs can put you in contact with people who may be able to help.
There are a range of options that may be able to reduce your insulin costs over the long-term.
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Best Support For Medtronic Users: Medtronic
Medtronic
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Reliable and courteous support staff
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Shipments arrive in a timely manner
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Offers technical support for using their equipment
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Your insurance must have contracts with Medtronic to get this product
Medtronic is a medical device company and a global leading producer of diabetes products, servicing more than 250,000 people with diabetes. It is often referred to as the best supplier of Medtronic supplies due to its efficiency, 24-hour technical support, and clinical support from other people with diabetes. Medtronic’s product line includes insulin pumps, continuous glucose monitors, sensors, and blood glucose monitors, to name a few. It also has blood glucose uploading software called CareLink, a free, web-based program that collects information directly from your diabetes management system, such as a continuous glucose monitor. You can generate printable reports that can be used during your doctor’s visits or for your own personal use to manage blood sugar. This software comes with a support system.
Artificial Pancreas Device Systems With A Low Glucose Suspend Feature
Threshold suspend is the first step towards an artificial pancreas device system . This technology combines CGMS with an insulin pump which allows the user to set a low blood sugar threshold value. When the CGM sensor detects the preset low glucose threshold, insulin delivery is suspended. There is currently one FDA approved device of this type: the MiniMed 530G System.
The MiniMed 530G System is intended for continuous delivery of basal insulin and administration of insulin boluses for the management of diabetes mellitus in persons, sixteen years of age and older, requiring insulin as well as for the continuous monitoring and trending of glucose levels in the fluid under the skin. This device automatically stops insulin delivery when sensor glucose values reach a preset level and when the individual does not respond to the threshold suspend alarm.
MiniMed Connect is an optional wireless device used to access continuous glucose monitor sensor data. Information can be viewed using an internet application through a smart device or via a browser accessible website and can be shared as needed.
Additional studies supporting the conclusions drawn by Bergenstal et al are needed to support an evidence base for use of the artificial pancreas device system with a low-glucose suspense feature. It should be noted that Medtronic, Inc.received Premarket Approval for the MiniMed 530G System,which is a threshold suspend artificial pancreas device system, on September 26, 2013 .
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Does Medicare Cover Diabetes Screening
Medicare coverage is available to beneficiaries with high-risk for diabetes. Detecting diabetes in the earlier stages may prevent future health complications. Depending on your situation, you may be eligible for up to two screenings each year.
And, if your condition is chronic, talk to your doctor about Chronic Care Management covered by Medicare.
Best For Surgical Supplies: Cascade Healthcare Solutions
Cascade Healthcare Solutions
Why We Chose It: Cascade Healthcare Solution sells four different categories of surgical supplies from trusted medical brands.
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Surgical supply categories include standard surgical packs, solutions, surgical supplies, and more
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Does not accept insurance or Medicare
Because many surgical supplies are sold wholesale, finding them to purchase individually can be difficult. Cascade Healthcare Solutions has been in operation since 2009 and offers surgical supplies for a variety of disciplines that can be purchased individually or via wholesale. Examples of these include knee arthroscopy, arthrogram trays, laparotomy packs, and more. Its products come from well-known companies, including McKesson, Medline, and Graham-Field.
In addition to surgical packs, Cascade Healthcare Solutions sells needles, syringes, and solutions such as sterile saline, lubricating jelly, and surgical prep solutions. As an example of pricing, a box of 144 foil packs of lubricating jelly costs $13.28 an incision and drainage tray is $89.64 and a piston irrigation syringe is listed at $38.62. Look for discount codes and free shipping options as you peruse the website. The company will ship internationally, but often for a minimum order amount that varies based on the product ordered.
The company does not accept Medicare or private health insurance, which according to its website allows it to offer wholesale prices to the public.
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How We Chose The Best Medical Supply Companies
We reviewed 25 medical supply companies before selecting the best ones for each category and only included companies that sell to consumers as well as businesses. Additional criteria included product availability, pricing, consumer reviews, and website navigability. We also examined shipping times, the number of back-ordered products, and return policies.
What Supplies Do People With Diabetes Need
Anyone with diabetes should have an individualized care plan because there are different types of diabetes and no two people are exactly alike when treating the disease. Many different variables dictate needs, such as: what type of diabetes you have, how long youve had diabetes, if you have complications of diabetes, how many times per day you test your blood sugar, what type of medication you are on, and more.
For example, if you have type 1 diabetes and take multiple daily injections using an insulin pen device, you will need pen needles, insulin, replacement pens or replacement insulin cartridges, a blood glucose meter, lancets, alcohol swabs, test strips, ketone strips, glucose tablets, glucagon, etc. If you have type 1 or type 2 diabetes and use insulin pump therapy with a continuous glucose monitor, you will need all the above supplies, in addition to infusion sets, sensors, insulin for your pump, tubing, etc.
Pump users are encouraged to have backup insulin at home in case there is a pump malfunction. If you are a person with type 2 diabetes and take oral glucose medication and have a history of peripheral neuropathy , you may need oral medication, a blood glucose meter, test strips, alcohol swabs, compression stockings, and diabetes shoes. Your diabetes care team will help you to understand what types of supplies you need and how long they will last before you need them to be refilled.
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Get Important News & Updates
Sign up for email and/or text notices of Medicaid and other FSSA news, reminders, and other important information. When registering your email, check the category on the drop-down list to receive notices of Medicaid updates check other areas of interest on the drop-down list to receive notices for other types of FSSA updates.
Lasette Laser Blood Glucose Monitoring Device
Aetna considers the Lasette laser blood glucose monitoring device , which uses a laser instead of a lancet to perforate the skin to obtain a blood sample for glucose measurement, experimental and investigational. There is insufficient evidence in the peer- reviewed medical literature that laser skin perforation offers clinically significant advantages over standard lancets.
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Best For Low Cost: Save Rite Medical
Save Rite Medical
Why We Chose It: Save Rite Medical offers discounts through its subscription program, free shipping over $100, and wholesale prices on many medical supplies.
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Offers 5% discounts on automatic reorders
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Free shipping over $100
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Pricing discounts for email subscribers
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Does not bill Medicare or insurance
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Return policy is 14 days
Save Rite Medical provides a wide variety of medical supplies at a low price, with discounts available on shipping and automatic reorders. The company has been in operation since 2008 and sells medical supplies in categories that include breast pumps, durable medical equipment, diabetes supplies, enteral feeding pumps, gloves, incontinence, erectile dysfunction, insulin therapy, orthopedics, ostomy supplies, and more.
Shipping is free with any purchases over $100. You can also sign up for the auto-reorder program , which allows you to order supplies automatically and have them delivered to you on a weekly or monthly basis at a 5% discount. There also are exclusive pricing discounts available by signing up for the company’s email list.
Save Rite Medical does not accept or bill insurance or Medicare, although it claims to be working toward accepting private insurance policies. The company’s return policy is 14 days, shorter than the 30-day window that we found with most companies we reviewed.
Complete Our Online Form
- To create a new account, complete our online intake here, or call us at
- Once your account is established, visit us at Our Portal to complete your Assignment of Benefits form which authorizes J& B Medical to submit claims to your health plan on your behalf.
- Our product specialists and nurses are happy to assist you with finding the products that will meet your medical needs and that are covered by your health plan.
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Artificial Pancreas Or Bi
An artificial pancreas is a closed-loop system with an insulin pump, real-time continuous glucose monitor and a small computing device to coordinate glucose sensing and insulin administration.
Closed-loop glucose management systems with a continuous glucose monitor and an insulin pump programmed with a computer algorithm that calculates insulin doses from the CGM readings and tells the pump to deliver or temporarily suspend or reduce insulin based upon specified thresholds of measured glucose levels.
The Biostator is a glucose-controlled insulin infusion system developed in the early 1980’s for use by a physician trained in the device. There are insufficient data in the published peer-reviewed medical literature documenting the safety and effectiveness of the Biostator. The Biostator is mainly used in research it is rarely used in clinical practice.
Best For Specialized Insulin Pump & Technology: Tandem
Tandem
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Advanced technology to help maintain glucose control
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Only available for people 6 years and older
Tandem Diabetes Care is the maker of the t:slim X2 insulin pump, which is approved for people with diabetes 6 years of age and older. Many people with diabetes prefer Tandem for maintaining tight blood sugar control due to its advanced technology. This insulin pump can be used with Basal-IQ and Control-IQ technology systems, which when paired with a compatible continuous glucose monitor can automatically suspend, increase, and decrease insulin delivery based on glucose monitor readings and predicted glucose values.
The technology is meant to help assist you with preventing glucose excursions . It is not meant to replace diabetes self-management such as blood sugar testing, paying attention to symptoms of low blood sugar, and carbohydrate counting. However, it is an added tool that can provide assistance to your daily diabetes routine. If you are using this insulin pump to manage your diabetes, you may choose to have your supplies delivered directly from the company.
Discuss with your physician if this is the right pump for you or your loved one. You may choose to request a pump online and have Tandem check your insurance for you. This process can be started online or you can reach out via phone, fax, or email.
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Continuous Glucose Monitoring Following Gastric Bypass And For Nesidioblastosis
Hanaire et al stated that hypoglycemia is rare after a gastric bypass and can be taken for a dumping syndrome. There is no report in the literature of the contribution of continuous glucose monitoring to the diagnosis of hypoglycemia in these circumstances. The present case report showed that CGM can be a useful tool for the diagnosis and the management of such episodes. Continuous glucose monitoring revealed hypoglycemic episodes in free living circumstances that were not present during 72-hr fasting. These episodes followed wide hyperglycemic swings. No such episode resumed over 8 months after specific dietary advices and treatment by 50 mg TID of acarbose. Because hypoglycemia can be difficult to diagnose from dumping syndrome, CGM is a very useful tool revealing the episodes in free-living circumstances and can be used to monitor the treatment success. The findings of this single-case study need to be validated by well-designed studies.
UpToDate reviews on “Medical management of patients after bariatric surgery” and “Complications of bariatric surgery” do not mention the use of continuous glucose monitoring.