Thanks to some help from @brighter1085293 I found an answer for you. The pharmacy is responsible for sending a correctly formatted Part B claim with both your Part B ID and your supplement plan ID. Common problems are your supplement plan is missing or incorrect on your CVS profile, the COBA (Coordination of Benefits Agreement) ID number is missing from the group field or the checkbox to bill the secondary is deselected.
Thank you for more info on this. I’ll put these items on my list to make sure another pharmacy does them.
I can’t believe my last CVS pharmacy told me they CANT send it thru Part B because Part B is for MEDICAL!
I’m at a frustrating loss to get FIASP insulin. Can someone provide a supplier that bills Part B for insulin?
I’ve lived with T1D for 58 years and graduated to Medicare. I recently switched to a ‘durable’ insulin pump (T Mobi) from a ‘disposable’ Omnipod 5. My Medicare Plan D (Rx) covered insulin administered by the disposable and blocks it after the switch to Mobi. Medicare Part B is supposed to cover insulin via durable pumps. But no local and chain pharmacy is set to bill Part B. I also checked numerous diabetes care suppliers whose sites specifically list that insulin can be sourced through them. Chat and phone reps confirmed they do not. So I can no longer get insulin dispensed via Medicare Plan D and cannot find a pharmacy that bills to Medicare Part B.
Please help. Can someone provide supplier(s) that bill Part B for insulin?
UPDATE 3/30/26 - I received a check today from CVS for the amount of $105.00. Refund for my 3-month supply of insulin aspart on 1/2/26. I still don’t understand what the deal is - why do they make it so difficult??? I’m still working through my 3rd pharmacy (Walgreens this time) of my next order of insulin. Seniors should NOT have to wait 3 months or a refund, I might add! I do realize my $ situation could be worse, but at least I got my $105 back!
Thanks for the commiseration and insights, jgbar1950. I’m unfortunately in Medicare limbo with Walgreens now and very interested to learn how it works out for you. Please keep us posted.
I think the intent of 100% insulin payment coverage by Part B is great. Disappointingly, its billing and payment implementation sorely lacks integrity. I’ve literally spent hours chatting, calling, web-searching, and waiting for call-backs, etc. to source a pharmacy to supply FIASP insulin with Part B. And I still have not found a source. It’s worse now since I’m down to my last vial and blocked and denied from getting insulin via Part D after switching to a durable insulin pump. In retrospect, paying $35 for a month’s supply of insulin doesn’t look too bad after all.
Hi CJ. The big retail chains that can bill Medicare Part B for Insulin are CVS and Walgreens. Maybe Walmart, my sample size is too small to know for sure. There are lots of midsize chains like grocery store and health plan pharmacies that can do it too, At the midsize level I’ve never found a company advertising they can do it so you have to go in and ask which leads to the next problem. Finding a location with staff trained on how to do it, are successful at training new hires how to do it and can manage the speed bumps. As demonstrated by @jgbar1950 Janice’s experience.
In my opinion based on talking to other people affected by diabetes on forums like this and https://www.reddit.com/r/WalgreensRx/ Walgreens is a pharmacy of last resort. Employee training is insufficient, they are actively pushing away customers and can’t keep drugs in stock. Some have great staffs and depending on your needs you may not notice the problems but why invest to the time to get setup with them if they are going to go out of business in a year or two assuming there are alternative where you live.
I haven’t seen any large mail order DME company selling fiasp. There was an explosion of small DME companies getting into diabetes in the last three years so keep looking after you get setup with a pharmacy.
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