Byram and Tandem supplies

I have just turned 65 and am attempting to set up my Medicare Part B coverage for Tandem pump supplies. Tandem gave me the names of three suppliers - Byram, CCS and Edgepark. I have read terrible reviews on all of them and after dealing with Byram for two months I know at least those are warranted. Despite having fresh bloodwork and an appt. with my Endo last month (and after sending Byram both chart notes and case notes) I am now being told I need to submit results from a C Peptide test. Neither I nor my Endo have record of me ever having a C Peptide test so now I have an appointment for another blood test. I am so frustrated I am contemplating forgetting Medicare’s so-called coverage and just buying supplies as I need them on the cheap. Anybody have any similar experiences or recommendations?

Hi @Babney welcome to TypeOneNation. I hope very much that our active Medicare members answer you but in the meantime I’d like to say that there are likely zero supplies you can get on the cheap. So in my opinion, jump through the hoops and get covered supplies if you can! Good luck :peace_symbol::shamrock:

Hi Joe! Thank you for the quick response. I have found expired supplies on secondary markets that are tempting. I’ll give Byram this one more go however even if I get the supplies I’m afraid they will try to bill me incorrectly after the fact.

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Oh @Babney I am sure the fun is only getting started! Check back in and I bet our experienced and knowledgeable group will have some good insights for you!

Oh, I will! It’s nice to have company on the ride :wink:

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@Babney Welcome Barb to the TypeOneNation Community Forum.

I’ve been using Byrum for pump and CGM supplies under Medicare and have never had any issues.

The c-Peptide requirement is not Byrum, but rather a Medicare requirement. I recall the Endocrinologist telling me when Medicare DEMANDED a c-Peptide reading Medicare didn’t believe the diagnosis I had received 55 years previously. And to top it off, 5 years later when I needed new pump Medicare demanded a new c-Peptide test because it was thinking I had been miraculously been cured!!! Oh, BTW, both c-Peptide tests, at a cost of $368 charged to Medicare, yielded a lab reading of >0.01% meaning the lab couldn’t’ detect peptide indicating I can’t produce insulin.

Bottom line, if you want Medicare to pay you must play its game.

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I have the same experience as Dennis. Medicare requires the c-peptide test that proved I do not produce insulin. I am on Original Medicare and they pay 100% of my Tandem pump, Dexcom cgm and insulin. I use Edwards Healthcare for my supplies and have good service with them. I get my insulin at my local CVS - be sure to tell them it is Medicare Part B with zero copay so it gets billed corectly.

Hi @Babney and welcome. As others have said the C-Peptide test is a Medicare requirement. Here is the info from Medicare: NCA - Insulin Pump: C-Peptide Levels as a Criterion for Use (CAG-00092N) - Decision Memo

Call or message your endo office and say you are starting on Medicare. They need to juggle a couple of things including the c-pep test, quarterly A1C tests, etc.

Where did you get your pump supplies previously? Did they say they don’t do Medicare Part B? Once the test is done it might be faster to stick with your original vendor. If not, you’ve already invested 60 days in getting set up with Byram, get your supplies from them and the day you receive your order start changing to another company. There are many more than the short list Tandem gave you.

So glad I turned to this forum! I decided to be a grown up and got the C-Peptide test this morning. Byram has already said they have re-opened my order so hopefully this will be what was needed. I have only been on the Tandem for four months so was still using the supplies I got from them. Will keep you posted and thanks again for the good advice.