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Does Medicare Cover Insulin Pens?

Christian Worstell by Christian Worstell    |    Published Nov 26, 2019    |    Reviewed by John Krahnert

Original Medicare’s benefits (Medicare Part A and Part B) are broad and it offers coverage for some medical devices. However, Original Medicare does not cover insulin pens.

Some Medicare Part D prescription drug plans or Medicare Advantage plans (Part C) that provide prescription drug coverage may cover insulin pens.

Learn more about your Medicare coverage options when it comes to insulin supplies like insulin pens.

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Does Medicare Pay for Insulin Pens, Needles or Pumps?

The population of diabetic people around the world is expected to grow, with a projected 366 million people with diabetes by 2030.1

One form of treatment involves the use of insulin pens, which can deliver doses of insulin in a disposable and discreet container. 

Original Medicare doesn’t pay for a variety of insulin-delivering tools or supplies such as:

  • Insulin pens

  • Gauze

  • Needles

  • Alcohol swabs.

In some cases, however, Medicare Part B may cover insulin pumps.

If a doctor states that it is medically necessary for you to use an insulin pump, the pump and the insulin supply may be covered as durable medical equipment under Medicare Part B medical insurance.

Some other diabetes equipment and supplies that are covered by Medicare Part B include the following:

  • Blood sugar (glucose) test strips

  • Blood sugar testing monitors

  • Lancet devices and lancets

  • Glucose control solutions

  • Therapeutic shoes or inserts

Medicare Part B also provides coverage for some services for people with diabetes:

  • Training in diabetes self-management

  • Annual eye exams

  • Foot exams

  • Tests for Glaucoma

  • Medical nutrition therapy services

In this situation, you’d pay 20 percent of the Medicare-approved amount for the cost of the insulin and pump (after you meet your Part B deductible, which is $198 per year in 2020).

Some of the 10 standardized Medicare Supplement Insurance (also called Medigap) plans available in most states cover the Medicare Part B deductible.

Each type standardized Medigap plan covers the Medicare Part B coinsurance or copayment.

How Do I Get Diabetes Supplies Covered by Medicare?

For most diabetic self-testing equipment and supplies, you need to get a prescription from your doctor in order for Medicare Part B to cover it.

The prescription should specify:

  • That you have diabetes

  • What kind of durable medical equipment (DME) you need and why you need it

  • Whether you use insulin

  • How often you should test your blood sugar

  • How many test strips and lancets you need (per month)

You can either order and pick up your supplies at a pharmacy that’s enrolled in Medicare, or have them delivered to your home using a national mail-order contract supplier.

Medicare beneficiaries may have other options to get coverage for insulin pens, insulin and other diabetic supplies that aren’t covered by Original Medicare.

  • One option is to enroll in a Medicare Advantage plan that provides prescription drug coverage. Medicare Advantage plans are sold by private insurance companies and are an alternative to Original Medicare.

    Medicare Advantage plans are required to provide all of the benefits that are covered by  Medicare Part A and Part B. Many Medicare Advantage plans also cover prescription drugs, which are not covered by Original Medicare.

    Some Medicare plans may cover insulin pens and other diabetes supplies.

  • Another option is to enroll in a Medicare Part D prescription drug plan.

    Some Part D plans may cover insulin pens, insulin and other diabetic supplies. Part D plans can be used in conjunction with Original Medicare and with Medigap plans (Medicare Supplement Insurance).

    You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Find Medicare Coverage for Your Insulin Pens

A licensed insurance agent can help you compare Medicare Part D prescription drug plans or Medicare Supplement Insurance plans that are available where you live.

While Medigap plans don’t cover insulin or insulin pens, they can help cover some of the Medicare out-of-pocket costs that you may face if Medicare covers your diabetes supplies, such as deductibles and copays.

 

Compare Medicare plan options in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 

1 TZ Ramadan, W., et al. Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon. (Mar. 27, 2015). Patient Preference and Adherence, 9, 517-528. doi: 10.2147/PPA.S78225.


 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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