I retired June 17, 2022 and have been going through the process of converting my working insurance to Medicare. This has been complicated by the fact I am a type 2 diabetic and waited a little later to retire.

I initially filed for Part A prior to my 65th birthday and did not opt for Part B at that time as I was still employed full time. I was assured that would not be an issue when I elected to start Part B at retirement. Once actually retired, it was an up hill battle to get Part B without penalty even though I could prove continuous insured status. The process and forms and phone calls made a very laborious process. Once completed, I still had to argue my Part B should not incur a penalty due to signing up later.

I believe the major issue is that one hand and group does not communicate with any other. I had to track down and speak with or fill forms for almost every situation and entity regardless what had already been surmounted and supposedly documented.

The latest events were the most arduous and I hope will be the last big issues I face. I wanted coverage for continuous glucose monitors (CGMs) and depending what source, they were not covered, covered by supplemental, covered by Part B, covered by supplement plans, etc.. In the end CGMs are covered by Medicare Part B only if the patient is insulin dependent though that fact itself was hard to establish after many forms and phone calls and conversations. I called in turn manufacturers Abbot (Libre & Libre 2), Dexcom (G6), suppliers, United Health Care (UHC, my MedicareRx and supplemental insurance provider), Medicare, my endocrinologist, my general practitioner (GP), and my local CVS pharmacy as well as OptumRx, my UHC MedicareRx mail service provider.

After all were seemingly in agreement, CVS still reported that Medicare was rejecting my prescriptions from the doctor. Medicare required specific documentation from my doctor which was not known or understood and apparently not communicated. I went from pharmacy to doctor to provider to manufacturer and repeated that cycle several times. Medicare said CVS was showing rejection internally on their computer system that was NOT being communicated or rejected by Medicare Durable Medicare Equipment (DME). He believed CVS was banking on patients paying cash through frustration and giving up.

Finally when the sensor and receiver appeared at CVS, the receiver was listed as covered but the sensor was still rejected by what seemed a Medicare message. The error appeared to be a code mistake which, once corrected, allowed purchase (covered, but not fully). I then found out that Dexcom required sensor, receiver and transmitter and still needed one final prescription.

Last night and today I have finally started using Dexcom G6 and I hope most of the process is behind me. While some Dexcom G6 attributes seem positive, so far I want to return to the fray and get my previous Libre 2 system supplied with new sensor patches. They require only two parts, sensor and meter. Hopefully, prescriptions going forward will start working without intercession.

Once again, Happy New Year. I hope 2023 is a steady improvement over the previous three years.