Medicare and Diabetes – What You Need to Know

Diabetes is one of the most common health conditions among seniors, impacting 25.2 percent of adults over age 65. Millions more are under diagnosed or living with pre-diabetes. Original Medicare covers free diabetes screenings for those who are at risk, and pays for many services and supplies for those who currently have the disease. If you have recently been diagnosed, and you’re wondering what to expect from your Medicare coverage.

Covered Diabetic Supplies and Services — Part B

Medicare Part B covers blood sugar self-testing equipment and supplies including glucose testing monitors and test strips, lancet devices, lancets and glucose control solutions for testing the accuracy of testing equipment. There may be limits to how much or how often you can get these supplies, and you may be required to use specific suppliers. If you use insulin, you may be able to get more test strips and lancets than someone who does not use insulin.

Part B also covers foot exams and treatment (including therapeutic shoes or inserts), yearly eye exams and glaucoma tests, insulin pumps and the insulin used by the device, nutritional therapy services and diabetes self-management training to help you learn how to better manage your disease.

Covered Diabetic Supplies and Services — Part D

Medicare Prescription Drug coverage (Part D) provides coverage for injectable insulin as well as supplies to administer insulin, like syringes, needles, alcohol swabs, gauze and inhaled insulin devices. Certain anti-diabetic drugs for controlling blood sugar with medicine, not insulin are covered as well.

Factors That Influence How Much You Pay

The amount that you need to pay for many of these services and supplies varies. However, there are some factors that can influence your cost. For instance, where you receive treatment, and whether or not your doctor accepts Medicare assignment can impact your cost. Note: Medicare does not cover all recommended diabetes treatment. If your doctor suggests you receive additional supplies or services beyond what Medicare covers, you may have to pay some or all of those costs.

National Mail Order Program

As long as you use a Medicare national mail-order contract supplier, you can have important diabetes testing supplies delivered right to your home. Medicare pays for test strips and lancets to be sent to you by mail. Or, you can pick them up locally at a drug store near you. In either case, you pay the same, whether you receive your testing strips in the mail or purchase them elsewhere. Local stores who accept Medicare assignment cannot charge more than your 20 percent coinsurance, and any unmet deductible.

 

References:
https://www.medicare.gov/coverage/diabetes-supplies-and-services.html

https://www.medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf pg. 6, 7, 8, 10, 11

https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf  pg. 2

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