[Ucrea] Navitus – Diabetic Supply Information for Medicare Plans

[Cristina L Otegui]

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August 17, 2022
To:
UCR Emeriti & Retirees

From:
UCR Benefits Office on Behalf of the Retirement Administration Services Center (RASC)

Re:
Navitus – Diabetic Supply Information for Medicare Plans

RASC would like to share with retirees and emeriti who are on the Anthem Medicare plans that additional information on the diabetic supplies claims process has now been added on the UC PPO Plans website at: https://www.ucppoplans.com/.

This information can be found on the UC PPO Plans website located:

·        under the Pharmacy section of the UC Medicare PPO webpage at: https://www.ucppoplans.com/medrx/about-the-plan/pharmacy.

·        under the UC High Option Supplement to Medicare webpage at: https://www.ucppoplans.com/high/about-the-plan/pharmacy.

Below is the diabetic supplies claim process information for easy access.

Diabetic Supplies
Medicare Part B is your primary insurance for diabetic supplies. Your Anthem Medicare PPO plan includes coverage for diabetic supplies under the Navitus MedicareRx pharmacy benefit. However, when ordering your diabetic supplies, Medicare Part B must pay as primary before your UC pharmacy benefit plan will pay as secondary.

The secondary diabetic supplies coverage is through your Navitus WRAP/Extra Covered Drug (ECD) benefit, not the Part D benefit.

Knowing how your plan pays for diabetic supplies can help you talk with your doctor and your pharmacy, and help you get testing supplies in a timely manner.

How Medicare Part B Works
Find a Pharmacy that Can Bill Medicare Part B

·        Ask your pharmacist if they can bill Medicare Part B for diabetic supplies. Most pharmacy chains — excluding Costco — can bill Medicare Part B, but some independent pharmacies are unable to. If your current pharmacy cannot bill Medicare Part B, you’ll need to choose a different pharmacy for your diabetic supplies.

·        You can search for network pharmacies near you by registering (if you haven’t already done so) and logging in to the Navitus member portal. The pharmacy directory will have each phone number listed so you can easily call to confirm whether they can bill Medicare Part B.

Submit the Prescription for Your Diabetic Supplies

·        Once you have found a pharmacy that can bill Medicare Part B, your doctor can send the prescription for your diabetic supplies to the pharmacy, or you can ask your old pharmacy to transfer your order to the new pharmacy.

·        Ask the pharmacy to bill Medicare Part B first and then submit it to Navitus MedicareRx for secondary payment.












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