Diabetic Supplies – Medicare and Insurance Coverage

As a provider of services to patients, you most likely understand the challenges of selecting a product for a patient and access to that product for the patient.  There are often times financial considerations for patients that need medical products due to insurance coverage.  At Prodigy, we offer quality products at a fair price in order to give a broader base of patients access to our products.  We are available on many commercial insurance plans nationwide.

For your uninsured patients

At Prodigy we understand that getting your diabetes testing supplies is important even if you have no insurance.  We work closely with Rx Outreach (a nonprofit organization) that can mail diabetes testing supplies to a patient at home for a low price.  Rx Outreach simply requires that the patient state that they cannot afford to purchase their product at traditional retail prices.

Medicare

Currently, Medicare is covering diabetes testing supplies through retailers like CVS, Walgreens, and Rite Aid and via mailorder providers as well.  The only difference today is that the patient copay is 14.5% less through mailorder than in retail.  Beginning in July 2013, Medicare will put into effect the competitive bidding scenario that has been coming for several years.  When that happens, the most likely effect will be that the copay differential will be even greater.  Mailorders will come a more cost effective channel for patients to receive their supplies, but perhaps with less brand choice available.

Medicaid

Most state Medicaid plans have opted to handle their coverage of diabetes testing supplies in a slightly different manner than Medicare.  Below is the coverage for Prodigy brand products by state:

California: Prodigy® Products available (pharmacist must dispense NDC# 08484-0528-70)

Missouri: Prodigy® Products available for patients with vision impairment

Georgia: Prodigy® Product preferred on state formulary