Does Medicare Cover Diabetic Supplies?
Medicare does cover certain diabetic supplies, such as some blood sugar monitors and lancets, though there can be limits to that coverage.
If Medicare covers your diabetic supplies, you may face out-of-pocket costs such as deductibles, copays and coinsurance.
A Medicare Supplement (Medigap) plan can help cover your Medicare out-of-pocket costs for diabetic supplies.
What Diabetes Supplies Does Medicare Cover?
The diabetes equipment and supplies that are covered by Medicare Part B (medical insurance) include the following:
Blood sugar (glucose) test strips
Blood sugar testing monitors
Insulin pumps (and insulin that the device uses)
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
Tests for Glaucoma
Medical nutrition therapy services
How Much Do Diabetic Supplies Cost With Medicare?
You must get your diabetic supplies from a participating pharmacy or supplier that’s enrolled in Medicare. Otherwise, Medicare won’t pay and you’ll be responsible for the bill.
If your doctors and suppliers are enrolled in and participate in Medicare, and if the supplies are considered medically necessary, Medicare typically covers 80% of the Medicare-approved amount, and you pay the remaining 20% (after you pay your yearly Part B deductible).
If Medicare covers your diabetic supplies, you will typically be responsible for paying certain out-of-pocket costs such as Medicare deductibles, copays and coinsurance.
A Medicare Supplement (Medigap) plan can help cover these diabetes supplies costs.
How Do You 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 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.
Does Medicare Cover Insulin?
Medicare Part B will not cover insulin unless it is used in an insulin pump. Medicare Part B also does not cover certain medical supplies used to administer insulin such as syringes, needles, insulin pens, alcohol swabs or inhaled insulin devices.
Medicare does not cover anti-diabetic drugs used to maintain blood sugar.
Medicare Beneficiaries With Diabetes May Have Other Coverage Options for Insulin and More
Although Original Medicare doesn't cover insulin, a Medicare Part D Prescription Drug Plan or a Medicare Advantage (Part C) plan that covers prescription drugs may provide coverage for insulin and other medications.
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.
If you are living with diabetes, talk to your doctor or health care provider to find out what testing and supplies are right for you and how often you’ll need them.
Find Medicare Supplement Plans That Help Cover Your Diabetic Supplies
A Medicare Supplement Insurance (Medigap) plan can help cover some of the Medicare copays and other costs for your diabetic supplies.
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient treatments and covered supplies.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
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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.