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Insurance Coverage & Shipping Guide: NYRx, Medicare & Nationwide

Navigating Your Benefits

We specialize in maximizing your coverage. Whether you are in Brooklyn or upstate, we handle the red tape.
 

  • NYRx (Medicaid): We are a preferred provider for the NYRx program. Most supplies (CGM, Wound, Incontinence) are $0 out-of-pocket with a valid prescription.
     

  • Medicare Part B: We bill Medicare directly for your clinical supplies. We ensure all "Medical Necessity" documentation is met so you don't get hit with surprise bills.
     

  • Managed Care: We work with most major NY plans (Healthway, Fidelis, etc.) to ensure continuity of care.
     

You shouldn't have to wait for life-saving supplies.
 

  • NYC & NYS Delivery: 1-2 day turnaround for all local orders.
     

  • Out-of-State / Nationwide: We provide authorized shipping for Medicare and specific private plans for patients traveling or living outside of New York.
     

  • Recurring Orders: Our system remembers your schedule. We ship your refills automatically so you never run out.
     

Reliable Delivery to Your Door

Maintaining Your Long-Term Eligibility

A common "hiccup" for patients is losing coverage after the first 6 months. To ensure uninterrupted supply delivery:
 

  • Follow-up Visits: Medicare requires a follow-up clinical evaluation every 6 months to document that the CGM is improving your glycemic control.
     

  • Competency Training: Your doctor must document that you (or a caregiver) have been trained to use the device. Palma Care DME provides the training resources to support this requirement.

FAQ: Insurance & Fulfillment

Will I have a co-pay for my Dexcom or Libre sensors?

For most NYRx Medicaid and Medicare with Supplemental (Medi-gap) plans, the out-of-pocket cost is $0. We perform a full benefits investigation before shipping to ensure you are aware of any potential costs.

Yes. We are experts in clinical documentation. We work directly with your physician to gather the "Clinical Notes" required by insurance, significantly reducing the chance of a denial.

Can Palma Care DME handle my prior authorization?

Absolutely. While we are headquartered in Brooklyn, we provide guaranteed 2-day delivery to all 62 counties in New York State and offer nationwide shipping for eligible Medicare patients.

Do you ship CGM supplies outside of NYC?

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