Does Medicare Cover Diabetic Supplies

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Are Diabetic Supplies Covered by Medicare?

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Medicare And Diabetes Coverage

Home / FAQs / Medicare Coverage / Medicare and Diabetes Coverage

Medicare and diabetes coverage is a concern for many Americans. Diabetes can cause a persons health and well-being to deteriorate over time. Close monitoring is often necessary because diabetes causes other health concerns and conditions. Below we go into full detail about what you need to know regarding Medicare and diabetes coverage.

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How Do I Cope With Finding Out I Have Diabetes

If youve recently received a diabetes diagnosis, take a big breath. Its easy to feel overwhelmed, but youre not alone. There are several ways you can cope with finding out you have diabetes and help you focus on maintaining your health.

Start by talking to your doctor. Theyre the best source of information about your diabetes. Theyll help you make a treatment plan and make sure you get the supplies you need to manage diabetes.

Talk to your family and friends and tell them how youre feeling. Be honest about your emotions and ask for help. Just telling someone else about your diagnosis can relieve stress.

Get the health benefits and savings youre entitled to.

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Wash Your Feet Every Day

What does Medicare Supplement Plan G Cover?

Wash your feet with soap in warm, not hot, water. Test the water to make sure it is not too hot. You can use a thermometer or your elbow to test the warmth of the water. Do not soak your feet because your skin will get too dry.

After washing and drying your feet, put talcum powder or cornstarch between your toes. Skin between the toes tends to stay moist. Powder will keep the skin dry to help prevent an infection.

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Other Durable Medical Equipment For Diabetes

Some people with severe diabetic disease will qualify for an external insulin pump. When your doctor prescribes an insulin pump, Part B will cover the pump and the pump supplies, including the insulin used in the pump.

This is an important distinction because people with Medigap plans that pay 20% can get this insulin at no cost once the deductible is met. Medicare covers 80% and most Medigap plans, like Plan G, will pay the other 20%. This can sometimes be very cost effective compared to insulin you inject yourself, which you must purchase under your Part D coverage.

What Brand Of Diabetic Supplies Are Covered By Medicare

When it comes to Medicare-covered diabetic supplies, the brand isnt the focus. How Medicare covers diabetic supplies focuses more on what types of supplies you need and whether or not they fall under the coverage limits for Original Medicare.

Diabetic supplies that may not be covered by Original Medicare may be covered by your Medicare Advantage plan, or a Medicare Part D Prescription Drug Coverage plan*. Before trying to use these types of plans to cover diabetic supplies, it is suggested to go over your plan to make sure your diabetic supplies will be covered by your plan, or plans.

*Diabetic supplies covered by Part D must be involved in the use of medications and prescribed by your doctor. Examples include insulin syringes or pens.

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Does Medicare Advantage Cover Podiatry

Some people decide to sign up for Medicare Advantage plans instead of getting their benefits directly through the government. Since Medicare Advantage delivers your Medicare Part A and Part B coverage through a private, Medicare-approved insurance company, you can expect that your foot care coverage is at least the same as described above. Some Medicare Advantage plans include additional benefits.

Fecal Occult Blood Test

Medicare & You: Diabetes

Medicare covers a fecal occult blood test once every 12 months for people aged 50 years or above.

The test checks for blood in the stool that a person cannot see with the naked eye. If the result is positive, it may indicate that some part of the digestive tract is bleeding. The bleeding may be due to many causes, such as ulcers or abnormal growths called polyps.

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What Parts Of Medicare Cover Diabetic Supplies

Diabetes supplies, services and prescriptions are covered by Medicare Part B, Medicare Advantage , Medicare Part D and Medigap plans.

However, the part of Medicare providing coverage can vary by the item or procedure.

Part B
Glucose monitor and test strips
Insulin
Foot exam and diabetic shoes
Diabetic eye exam
Diabetes screening
Medicare Diabetes Prevention Program

In order for diabetic supplies to be covered, the rule of thumb is that they must be considered medically necessary and prescribed or approved by your physician. With Medicare Advantage plans, you may sometimes also need preapproval from your insurance company.

Medicare Part B a component of Original Medicare provided through the government covers diabetes services such as doctor appointments, screenings done by the doctor, the Medicare Diabetes Prevention Program, foot exams and glaucoma eye exams. It also covers supplies called “durable medical equipment” including external insulin pumps, diabetic shoes, home glucose monitors and test strips.

Medicare Part D a stand-alone prescription drug plan is how those with Original Medicare get coverage for anti-diabetic medication, insulin and supplies to administer insulin such as syringes and insulin pens. The one notable difference is insulin used with an insulin pump is covered by Medicare Part B as part of its durable medical equipment coverage, but injectable or inhalable insulin is a part of your prescription drug coverage.

When Should I See My Health Care Provider About Foot Problems

a cut, blister, or bruise on your foot that does not start to heal after a few days
skin on your foot that becomes red, warm, or painfulsigns of a possible infection

a callus with dried blood inside of it,which often can be the first sign of a wound under the callus
a foot infection that becomes black and smellysigns you might have gangrene

Ask your provider to refer you to a foot doctor, or podiatrist, if needed.

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What Do Medicare Part B And Medicare Advantage Plans Cover

Medicare Part B covers diabetic test supplies, screenings, and education for beneficiaries with diabetes, or for those who are at risk for diabetes.

Medicare Advantage, also called Medicare Part C, is optional private insurance. Medicare Advantage plans cover the same diabetic supplies and screenings that Medicare Part B covers. Medicare Advantage plans are required to provide at least the same amount of coverage as Original Medicare , except for hospice care.

Medicare Part B covers diabetic supplies such as:

Blood sugar monitors
Therapeutic shoes or sole inserts, if you meet all of these conditions:

You have diabetes and youâre being treated under a comprehensive diabetes care plan.
You need therapeutic shoes or inserts because of your diabetes.
In one or both feet, you have any of these: poor circulation, past foot ulcers, calluses that could lead to foot ulcers, deformity, nerve damage and potential callus problems because of diabetes, or partial or complete amputation.

If you get therapeutic shoes or inserts, a podiatrist or other qualified doctor must prescribe them, and a doctor or other qualified individual like a pedorthist, orthotist, or prosthetist must fit and provide the shoes or inserts.

Medicare Part B covers diabetic services such as:

Foot exams every six months

Medical nutrition therapy

How Do I Find A Medicare Diabetes Test Strips Supplier

Medicare maintains a list of national and local suppliers of diabetes supplies. You can visit Medicare.gov/supplier and input your zip code to find suppliers that serve your area. However, its possible that youll need to contact multiple companies as every supplier may not have your blood glucose test strips of choice.

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What Does Part D Cover

Medicare Part D will cover medications such as insulin and the tools like needles and syringes you need to inject your insulin. It also covers your routine medications at home.

Medical supplies to administer insulin
Inhaled insulin devices

Part D is a private plan, and you must be enrolled in Part A or B to be eligible.

Smart Insulin Pens Insulin Pen Needles And Syringes

Devices used to administer insulin– including insulin pens, needles, and syringes – are covered under Medicare Part D for Medicare patients with diabetes. One unique product in this category available from US MED® is the InPen, a smart insulin pen that offers personalized recommendations for insulin dosage. Along with that, we carry needles and syringes in various sizes.

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Does Medicare Cover Diabetic Test Strips

Yes, Part B pays for diabetes supplies such as test strips. You may qualify for as many as 300 test strips every three months if you need insulin. Patients not using insulin may be eligible for up to 100 test strips every three months.

There may be limits on how many and how often you may get these supplies under your plan. Part B also covers supplies such as blood-sugar monitors and test strips.

Other DME supplies like lancets, glucose control solutions, and devices have coverage. Your doctor must document that Medicare must allow any extra strips or lancets. Moreover, documentation of how often youre treating yourself is necessary.

Best For Replacements: Dexcom

Medicare Now Covers Continuous Glucose Monitors!

Reliable continuous glucose monitor that is compatible with many insulin pumps
Easy replacement forms can be filled out online

Youll need to have other diabetes supplies delivered from a separate company. Dexcom delivers only Dexcom supplies.

Dexcom, a type of Continuous Glucose Monitor , is used to help you check your blood sugars, identify trends, and alert you if your levels are trending high or low. Dexcom provides great flexibility in the delivery of supplies. Simply filling out a form online can determine if you are eligible for the product. And, if you have pharmacy coverage through your insurance, you can get your supplies delivered directly from your pharmacy. If you dont have pharmacy coverage, you can continue to receive supplies from Dexcom or your insurance-designated distributor.

CGM systems like Dexcom take glucose measurements at regular intervals throughout the day and translate them into information to demonstrate trends. These readings are used to help manage diabetes. A Dexcom user told us that in the instance she has a faulty sensor, she deals directly with Dexcom and has no problem getting replacements sent directly to her quickly and easily.

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Therapeutic Shoes And Inserts

Medicare Part B may also cover therapeutic shoes or inserts if you need them for your diabetes, but you have to meet certain conditions. You may qualify for one pair of depth-inlay shoes and three pairs of inserts per year.

If you cant wear depth-inlay shoes, Medicare may pay for one pair of custom-molded shoes and two pairs of inserts.

You have to meet certain conditions, including being diagnosed with diabetes, are in a comprehensive treatment plan and require the shoes and inserts.

You also must have at least one of these conditions:

Diabetes-related nerve damage with signs of callus problems

Partial or complete foot amputation
Poor circulation

You will also need a podiatrist or other qualified health care professional to prescribe the shoes and to fit and provide them.

What Diabetes Supplies Will Medicare Pay For

Yes, Medicare Part Bcovers some diabetes supplies, including:

Hearing coverage
Health and Wellness program benefits, such as gym memberships and SilverSneakers

Staring in 2019, Medicare Advantage plans may be able to offer even more additional benefits, including home delivered healthy meal options, which could help some beneficiaries with diabetes better manage their health and diet.

Some Medicare Part D prescription drug plans may also cover certain diabetes supplies, insulin and other diabetes medication.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.1

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Medicare Coverage For Diabetes

The Centers for Medicare & Medicaid Services reports that 26.4 million people aged 65 years or older have prediabetes. Of the entire U.S. population, 38% of adults have prediabetes, and 11.3% have diabetes.

Though these statistics are alarming, increasing awareness of the disease has helped educate and support people with diabetes to better cope with health concerns and healthcare costs.

TIP: Try the Medicare plan finder if you are looking for a Medicare plan to help with diabetes.

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What Diabetic Services Does Medicare Cover

4 min read / Written by

The first fact you need to know is that you must be enrolled in Medicare Part B for Medicare to cover your diabetic services or supplies. If you have a Medicare Advantage plan, youre required to be enrolled in both Medicare Part A and Part B, so as long as you continue paying your Part B monthly premium, you should be covered as described below.

If youre not sure whether youre enrolled in Medicare Part B, look at your red, white, and blue Medicare card, or contact your current health insurance provider.

Medicare Part B covers the following diabetic services, generally requiring your Medicare-participating doctors order:

Diabetes screening: Medicare covers tests to check for diabetes if youre considered at risk for the disease. These screenings may include tests such as a fasting plasma glucose test, or other Medicare-approved tests your doctor may order for you. Medicare may cover these screenings up to twice a year, depending on your risk factors.
Diabetes self-management training: For qualified beneficiaries, Medicare offers a training program that teaches you how to manage your diabetes. It includes education about self-monitoring of blood glucose, diet, exercise, and prescription medications. If you meet certain conditions, Medicare may cover 10 hours of initial diabetes self-management training, to be completed within a year, and two hours of follow-up training each following year.

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What Diabetic Supplies Are Covered By Medicare

In order to have your supplies covered by Medicare, you musthave a prescription from your doctor, and receive the items over the counterfrom an authorized seller. The items must also be on Medicares approved list,otherwise they wont be covered.

Your local pharmacy is most likely an authorized seller, butits best to confirm with them that they accept Medicare before making yourpurchase. If you buy your supplieswithout a prescription, or from a seller thats not authorized, Medicare wontcover any of the costs.

Medicare Part B covers the following supplies, if they areprescribed by your doctor following their guidelines:

Glucose test strips

How Do I Get Free Diabetic Supplies

Its no secret that diabetic supplies can get pricey. Buying glucose monitors, test strips, and insulin can add up fast. Thankfully Medicare has you covered if you know how to get the right supplies.

To receive free diabetic supplies youll need to work closely with your doctor to get appropriate supplies. Your doctor will write you a prescription for all the supplies, equipment, and medication you need.

Your doctor will help you find the right blood sugar monitor for you and explain how often you should test your blood sugar levels. Theyll also determine how many lancets or test strips youll need in a month. You wont get coverage for any additional supplies that your doctor doesnt prescribe.

Youll need to get a new prescription for diabetes supplies every year. This is a great time to evaluate your treatment and make sure its right for you.