Sept. 08 Marci's Medicare Answers

Dear Marci, I have had diabetes for many years and will be eligible for Medicare in September. Does Medicare pay for my monitoring supplies? --Ed Dear Ed, Yes, Medicare will cover certain diabetic supplies, such as glucose monitors and control solutions, lancets, and test strips. You can get these benefits even if you don't use insulin. If you use an insulin pump, the insulin and the pump may be covered as durable medical equipment under Medicare Part B. Contact your Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for more information. To find the number of your local DME MAC, call 1-800-MEDICARE. If you inject your insulin with a needle (syringe), the Medicare drug benefit (Part D) covers the cost of insulin and the supplies necessary to inject the insulin, including syringes, needles, alcohol swabs and gauze. Medicare will pay 80 percent of the Medicare-approved amount of all covered diabetes supplies and services, after you have paid the yearly Part B deductible. (If you are in a Medicare private health plan-HMO or PPO-you may have a copay for these services. Call your plan to find out what you will have to pay.) --Marci Dear Marci, I have had Pap smears every year, but last month when I went for my exam, I was told that Medicare won't pay for my exam this year. Why might this be? --Helen Dear Helen, Original Medicare covers 100 percent of the cost of one Pap smear every two years for all women with Medicare (if you are in a Medicare private health plan you may pay a copay). If you are in your second year with Original Medicare, and had a Pap smear last year, and you are generally healthy, you will not have another one covered until next year. However, if you are considered at high risk for cervical or vaginal cancer (e.g. have had a sexually transmitted disease or your mother was given the drug diethylstilbestrol (DES) during pregnancy), or are of child-bearing age and have had an abnormal Pap smear in the past 36 months, Medicare covers the cost of one Pap smear a year (every 12 months). Medicare will cover the full cost of your Pap lab test, 80 percent of the cost of the Pap test collection, a pelvic exam (used to help find fibroids or ovarian cancers) and a clinical breast exam. Medicare will cover all of these services with no Part B deductible required. --Marci Dear Marci, I applied for Extra Help paying for Medicare drug coverage (Part D) and was denied. Is there anything I can do? --Vincent If it is before you receive the final decision-you get a notice from the Social Security Administration (SSA) saying you may be denied because your application is incomplete-you can correct your application. If you received a "Notice of Denial" from SSA saying that you do not qualify for Extra Help, and if you disagree with that decision, you can appeal. It is best not to reapply for Extra Help and appeal instead, because if you win, your Extra Help will be effective from the first day of the month that you originally submitted your application. To appeal you should request a review of your case (a hearing) within 60 days of receiving SSA's decision. If you do not want a hearing, you can just ask for a "case review," where an SSA agent will review your application and any additional information you send in. --Marci Marci's Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation's largest independent source of information and assistance for people with Medicare. To subscribe to "Dear Marci," MRC's free educational e-newsletter, simply e-mail dearmarci@medicarerights.org. To learn more about the services that Medicare will cover and how Medicare works with Medicaid, log on to Medicare Interactive Counselor at the Medicare Rights Center's website at www.medicareinteractive.org.