Does Medicare Cover V-Go?

If you’re an insulin-dependent diabetic, maintaining good health depends on the correct hormone dosage. Basal is a long-acting form of insulin that will keep your blood glucose levels steady when you’re not eating. It may help your cells use the glucose your body releases during this time as energy. On the other end of the spectrum, short-acting insulin, called Bolus insulin, may help control your blood glucose levels when you eat. You can take it before, during, or after your meals. You’ll follow the basal-bolus insulin injection routine to ensure you get better control over your blood sugar levels. It also gives you more flexibility when you eat, but you’ll end up giving yourself more injections unless you use a system like V-Go. Do Medicare benefits cover V-Go?

Medicare Benefits Solutions

Feb 5, 2021

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Defining V-Go

V-Go is a lightweight, small device that you wear that gives you a continuous delivery of your basal-bolus insulin routine. V-Go is a device that will get rid of the need to self-inject insulin into your body several times throughout the day to keep your blood sugar in check. 

You simply fill the V-Go system with your insulin using a disposable filler. The V-Go machine then goes on your skin like you’d put a patch on. You put it in the same spot where you inject yourself. When you get it situated, you push the start button, and it’ll start working. 

There are dual mechanisms inside the V-Go system. They will give you both forms of insulin delivery. When you don’t eat, it’ll release a steady stream of basal insulin. There is an on-demand bolus insulin system for meals or snacks. You’ll have to push a button when it’s time to get the bolus insulin for it to work correctly. You can wear it under your clothing, and it only weighs in at around one ounce. 

Medicare bnefits and V-Go

If your Medicare plan doesn’t have prescription drug coverage, you could pay around $250 for a one-month supply of the disposable insulin delivery devices V-Go uses. A one-month supply of insulin ranges between $275 to $500, depending on where you live. You have to fill the device with a new insulin delivery system every 24 hours. 

Part D prescription drug coverage may help cover the cost of V-Go. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP). You could also enroll in a Medicare Advantage plan that includes prescription drug coverage. Most Medicare Part D formularies will cover the V-Go system, but it’s always best to double-check your plan’s specific prescription drug formulary. 

The final cost for the system will depend on where you buy the device and insulin. It also depends on which tier the system is on. For example, the first tier with Part D is generic prescriptions, and it has the lowest costs. The second tier has preferred name-brand drugs that are slightly more expensive. The final tier has the highest copay, and it includes name-brand, non-preferred medications. 

On average, the entire V-Go system with the refill devices and insulin will cost $1,925.71 to get you started. After that, you’ll pay for the refill devices and insulin. You also have to pay your deductible and any copays. 

It’s important to note that systems like V-Go may not work well for everyone. If your primary care provider suggests trying it to help improve your health and control your blood glucose levels, you want to contact your specific Medicare plan for more details about your coverage and costs.

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