The simple answer is yes; Medicare covers some diabetic supplies. It also provides coverage for services that can help you treat or prevent diabetes. How much you have to pay out-of-pocket depends on whether or not you have other insurance.
How Much Does Medicare Pay for Diabetic Supplies?
Medicare alone doesn’t pay in full for most medical services, including diabetic supplies. Medicare Part B (which is your outpatient coverage) covers about 80% of the costs of a variety of supplies that are used to treat diabetes. Part B will typically cover these services and supplies up to 80%, leaving you responsible for the other 20% as well as any deductibles or copays. In order to help with the expenses, most people have a Medicare Supplement plan or a Medicare Advantage plan.
It’s important to note that Medicare Supplement plans range in coverage, and they’ll all pay their portion as long as Medicare pays first. The cost of your supplies may differ depending on which Medicare Supplement plan you choose.
If you have a Medicare Advantage plan, it’s your primary coverage instead of Medicare. For information on what your Advantage plan covers, you should contact your provider directly.
What Diabetic Supplies are Covered by Medicare?
In order to have your supplies covered by Medicare, you must have a prescription from your doctor, and receive the items over the counter from an authorized seller. The items must also be on Medicare’s approved list, otherwise they won’t be covered.
Your local pharmacy is most likely an authorized seller, but it’s best to confirm with them that they accept Medicare before making your purchase. If you buy your supplies without a prescription, or from a seller that’s not authorized, Medicare won’t cover any of the costs.
Medicare Part B covers the following supplies, if they are prescribed by your doctor following their guidelines:
- Glucose test strips
- Blood sugar testing monitors
- Glucose solution
- Blood sugar control solution
- Therapeutic shoes or inserts
- Insulin pumps
Does Medicare Cover Insulin?
While Medicare Part B normally doesn’t cover insulin, it may cover it if you have a Medicare-approved insulin pump. You can check with your provider for more information, or to see if you qualify. Otherwise, you can check your Medicare Part D Prescription Drug plan to see what types of insulin are covered.
What Services Does Medicare Cover for People with Diabetes?
Medicare Part B covers the following services specifically to help you manage your diabetes. Keep in mind that if you don’t have a Medicare Supplement plan, you may be responsible for some out-of-pocket costs.
- Yearly eye exams
- Self-management training
- Foot exam
- Glaucoma tests
What are the Diabetic Supplies Medicare Doesn’t Cover?
Medicare Part B doesn’t cover the following supplies; however, your Part D Plan may cover them:
- Syringes and needles
- Alcohol swabs and gauze
- Devices used to inhale insulin
How Can I Minimize My Out-of-Pocket Costs When Buying Diabetic Supplies?
There are several steps you can take to ensure that you don’t pay more for your diabetic supplies than necessary.
- Enroll in a Medicare Supplement plan to limit your out-of-pocket costs from Original Medicare (Medicare Part A and Part B)
- Enroll in the Medicare Part D Prescription Drug plan that saves you the most money
- Get a prescription from your doctor for your supplies
- Purchase your supplies over the counter from a pharmacy that accepts Medicare
Diabetes can be difficult and expensive to manage, and you may find the services that Medicare offers helpful. If you’d like to learn more about how to take advantage of the benefits Medicare provides, contact your healthcare provider for more information.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.