Frequently Asked Questions
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Q. Who is responsible for getting the insurance authorizations for medical supplies?
A. CCS Medical has a team of experienced authorization specialists who will oversee the process. Our knowledgeable staff will contact the ordering physician when applicable and the insurance company to verify coverage and obtain authorization for the product.
Q. Does the company provide service and supplies to Medicare and Medicaid patients?
A. Yes. We are a participating provider with Medicare as well as most Medicaid and many Managed Care plans.
Q. Are you a participating provider with other insurance companies?
A. Yes. Our company is contracted with hundreds of insurance providers nationwide. Our knowledgeable customer service team works on a daily basis with hundreds of private health insurers. We add insurance company contracts on an ongoing basis and will be happy to contact any carrier necessary to assist you in meeting your supply needs.
Q. Are all products covered by my insurance company?
A. Coverage varies from one insurance company to the next. As part of our service, we determine if a particular product will be covered.
Q. How much will a patient have to pay for his or her product?
A. It depends on the insurance plan and the patient's policy. All patients will be responsible for any co-pays or deductibles that their insurance company may have in place. Our specialists will help explain the patient's financial responsibilities.
Q. Do I need to apply for Medicare when I turn 65?
A. No. If you are already getting social security or railroad retirement benefit payments, you will automatically receive a Medicare card in the mail about three months before your 65th birthday as part of an enrollment information package. The card will usually show that you are entitled to both Part A (hospital insurance) and Part B (supplementary medical services). It also indicates the beginning dates of your entitlement to each. If you do not want Part B, follow the instructions that come in the package.
Q. Who can receive benefits for diabetes testing supplies and diabetes self-management training?
A. All Medicare beneficiaries with diabetes (insulin treated and non-insulin treated) are eligible for coverage of diabetes testing supplies. Individuals covered by Medicare who are at risk for diabetes-related complications and meet other requirements can receive training if it is requested by their doctor or other qualified provider.
Q. How do I know my diabetes supplies are covered by Medicare?
A. CCS Medical will verify your eligibility and benefits prior to sending your first shipment to ensure your supplies will be covered by Medicare. Deductibles and co-pays may apply.
Q. How much is reimbursed for each product?
A. After you have paid your annual Medicare Part B deductible, Medicare will reimburse 80% of allowed amount or 80% of the billed amount, whichever is lower.
Q. Does everyone pay the same amount for the Part B premium?
A. The premium is usually paid by the individual, either through deductions from social security checks or direct billing. The state you reside in may pay Medicare premiums if your income is low enough. Most people pay the same premium amount.
Q. Are there limits on the quantity of diabetes supplies that Medicare will reimburse?
A. Medicare establishes certain limits based on whether or not you use insulin injections to treat your diabetes. Your physician will indicate how often you should test. Medicare may cover additional testing supplies if your physician determines it is medically necessary.
Q. When will Medicare cover additional test strips and lancets?
A. Medicare will cover additional strips and lancets when the following criteria are met: - The patient's physician has seen the patient within the last six months and has evaluated their diabetes control. - The physician has documented in the patient's medical record the specific medical reason for the additional strips and lancets for that particular patient. - The patient keeps a testing log book in their medical records or otherwise documents their actual testing frequency. The patient must provide the supplier with a copy of one month of test readings every six months. - The patient's physician provides a written order for the frequency of testing that is greater than established utilization limits.
Q. How do I replace my Medicare card?
A. Please call the Social Security Administration (SSA) at 1-800-772-1213. A representative can request that a replacement Medicare card be sent to you. The best time to call is Tuesday through Friday between 7 a.m. and 7 p.m. Make sure you have your Medicare number handy. You should receive the replacement card in four weeks.
Q. If I am 65 and ready to retire and my employer is going to provide me with benefits, do I need Medicare?
A. Yes. Medicare pays first in all situations unless you (or your spouse) are eligible under an employer-sponsored group health plan. If you have other insurance and have questions about who pays first, call the Medicare Coordination of Benefits Call Center at 1-800-999-1118.
Q. Does Medicare cover my spouse and family?
A. In general, Medicare is "individual" insurance. However, sometimes spouses and children can become eligible for Medicare based on the wage earner's work record. For questions about Medicare eligibility, contact the Social Security Administration at 1-800-772-1213.
Q. Where should I send my Medicare premium payment?
Medicare Premium Collection Center Post Office Box 371384 Pittsburgh, PA 15250
Q. Who can I contact for more information about Medicare eligibility?
Please contact the Social Security Administration at 1-800-772-1213 or go to www.medicare.gov.