So some of these are documented medical conditions for which you would have “proof”, but what about proving you’re a former smoker or physically inactive? And who does this “proof” go to? I hate it here.
Replies
Why do I have a feeling this is gonna be a mess
aug 28, 2025, 3:00 am • 21 0 • view
You have been able to watch the omnishambles of Trump 2.0 since January 20.
aug 28, 2025, 3:28 am • 2 0 • view
I want to blow smoke in the pharmacists face. Will that do?
aug 28, 2025, 5:00 am • 2 0 • view
I have a feeling pharmacists are just going to give it to people no matter what.
aug 28, 2025, 4:51 am • 22 0 • view
Nor if they won't get paid for it
aug 29, 2025, 11:03 am • 0 0 • view
God, I hope so. They could just write up doctor’s notes for “physical inactivity” so the insurance companies don’t punish their patients for having “pre-existing conditions” later.
aug 28, 2025, 6:30 am • 10 0 • view
Sometime they can't. Depends how FDA sets it up. With an autoimmune disease during Covid I wanted to get the RSV shot but "wasn't old enough." They said the "computer wouldn't allow it." Whatever that meant. I'd have to go to my Dr and either get a note or hope she had access to it.
aug 28, 2025, 8:14 pm • 1 0 • view
If you get it from your MD. Don't even need any of the conditions. Drs. can prescribe things "off label" if they want. This mainly prevents or discourages the public from going to Walgreens and having the pharmacist give them the Covid vaccine. But who can argue that you're not physically active?
aug 28, 2025, 6:41 am • 1 0 • view
Yes, practitioners can but insurance doesn't need to agree to reimburse you. Be prepared for a fight or paying OOP.
aug 28, 2025, 1:11 pm • 0 0 • view
Insurance companies don't have to reimburse, but they probably will. Because unvaccinated patients cost them money.
aug 29, 2025, 3:33 am • 1 0 • view
They don't cover cholesterol screening for Medicare patients. They don't follow reason.
aug 29, 2025, 4:48 am • 0 0 • view
Medicare does cover cholesterol screening.
aug 29, 2025, 4:51 am • 0 0 • view
www.medicare.gov/coverage/car...
aug 29, 2025, 4:53 am • 1 0 • view
Once every 5 years. If you are started on medication for high cholesterol, the patient must pay for any screening to determine medication effectiveness. They also do not cover B12, D3 or any other vitamin levels. Sucks if your a anemic as many elderly are. B12 levels cost about $130.
aug 29, 2025, 5:06 am • 0 0 • view
Not true. If you are put on cholesterol meds Medicare will pay for additional blood tests for maintenance. The doctor needs to know if the medication is working. Screening is for healthy people once every five years.
aug 30, 2025, 1:52 pm • 1 0 • view
You weren't talking to someone with knowledge of the rules.
aug 30, 2025, 9:14 pm • 0 0 • view
I've been fighting for years. Insurance companies are now using AI to determine coverage via algorithms. Some people will get covered, some won't. I've had procedures denied by a group where the medical "expert " was a retired dentist. I won on appeal, but It is getting worse.
aug 30, 2025, 11:53 pm • 1 0 • view
I guess all that time I was on the phone was imagined then. Okay. Ta
aug 30, 2025, 3:39 pm • 0 0 • view
Ok, so Medicare covers cholesterol screening. A screening test is a test performed in healthy people before treatment. Medicare also covers B12 levels, when medically necessary. seniorsinfo.org/medicare-ins...
aug 29, 2025, 5:16 am • 2 0 • view
I know all this info but wait until you're the one fighting for them to cover it even when medically necessary. I am tenacious and like a dog with a bone, but many seniors are intimidated by the process as they double talk at each level. It is also ridiculously time consuming.
aug 29, 2025, 5:23 am • 0 0 • view
Once every 5 years.
aug 29, 2025, 5:07 am • 0 0 • view
If you have high cholesterol Medicare will pay for more frequent tests. It's just the initial test that's once every five years if they discover your lips levels are normal. My insurance pays for a full blood screen and urine screen every year.
aug 30, 2025, 1:32 pm • 1 0 • view
How would I have proof? I am NOT handing over medical records (which would be difficult to get anyway) to a fucking pharmacist.
aug 28, 2025, 6:21 pm • 0 0 • view
Yea, and who is defining these conditions? How do you define “smoker”, what’s the rubric? Does it only count if you smoke(d) a pack a day? And how do you define “physically inactive”? Low daily step count? None of this makes sense. Color me shocked.
aug 28, 2025, 11:55 pm • 0 0 • view