Struggling to Get Colostomy Supplies Covered by Insurance

Since moving to Kansas City I am having issues with Aetna Medicare covering my colostomy supplies that were always 100% covered when I just had regular original Medicare. I have Medicare but I now have primary as Aetna Medicare and Kansas Medicaid but now I can't get my colostomy supplies covered cuz they're saying they're not apart of the coverage that I have for part b is anyone else having issues in getting their insurance to cover their colostomy supplies since this new change in how private companies are able to take over the federal Medicare program.<

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EDIT: I'm being told by Aetna that my ConvaTec durable stoma barrier #421040 is not covered but the pouch #416420 is. That my co-pay is $28 per box. I keep getting nothing but a run around and to answer the question on how many bags I have left. I have 7 bags total as of today. I've been trying since November 2019 to get a reorder in. But Kansas has changed so much in it's insurance regulations that I'm being screwed. Here soon I'll be duct taping Walmart bags to my stoma just to catch my bowel movements. <

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Thanks for dating your profile. U have been through the mill big guy.. geez.. I can't help you with medicare or medicaid issues.. but if you feel you're stuck and need supplies like these bags, people here are taking measures to get their excess bag to people who need them.. just ask but also list the type of bag u need... or wafer.. and people will get back to you.. might have to open a new thread for that tho... these insurance companies need an enema. so list what type of bag u need. ok.. maybe this could help you out till things get sorted.--Warrior.

Hey Auto,

Have you talked to Aetna about your plan? Does it not have “durable medical”. It should. Insurances job is to keep their money as long as they can while taking your as quickly as they can! Aetna is an Medicare Advantage Plan. They have copays and large out of pockets but do have a max per year but it is like $6850 per year. They Pay 80% and you the 20% till that max is paid by you and then they pay 100%.Traditional Medicare pays the same but has no max out of pocket per year. If you have Medicaid as secondary, you do not need that max allowed out of pocket. Did you change for a reason. Sometimes advantage plans are represented as an “advantage” and they seldom are!
Did you Change for a specific reason? Just curious. If your Aetna plan does not cover Ostomy supplies which is very weird so I would call them. Second, your Medicaid should pick up the cost once Aetna denies if they really do not cover the supplies. If you do not have durable medical, Medicaid needs to know that!
Now if you need supplies in the meantime,
There are several supplies listed under Surplus Supplies. You can contact the people that have thing to give maybe through a private message. I am one of them and depending on what you use and your ability to adapt to other supplies, maybe we can get you through this bump! Please check out the forum topic. You will have to skip down through the comments to find some supplies! We have lots of comedians on there! Lol they are a riot!
Let me know what you need and when! Time is always important. How close you are to being out! Look forward to hearing from you through private message. If you are not a full member, let me know, I will message you first and you can respond.
Puppyluv

If you still have Medicaid and Aetna(medicare) the total s/b paid.  I had Medicaid and Medicare and I didnt have to pay 4 ostomy supplies.  Just ask medicaid for their "preferred supplier" for ostomy supplies.

Check with Aetna. It may be an issue of the SPECIFIC wafer or pouch you are trying to get, and switching to a different brand or style may be covered. Get them the to tell you the specific reason why it isn't covered, and what alternative is covered. I am in Kentucky, not Kansas, but the Medicare should be primary (I believe), and should pay 80% of both wafers and pouches, and the Medicaid should pay the other 20%. Unless you happen to get some specific something that isn't covered, and there should be an alternative that is.

Words of Encouragement from Ostomy Advocates I Hollister