Diabetes and Medicare: What’s Covered?
December 3, 2018 | Tom Peterson
Many people who are enrolled in Medicare have questions on how diabetic self-testing equipment and supplies are covered. Blood sugar (also called blood glucose) self-testing equipment and supplies are covered as durable medical equipment (DME) for all people with Medicare Part B who have diabetes, (even if these members do not use insulin).
Diabetic Supplies Covered By Medicare
Blood sugar (also called blood glucose) self-testing equipment and supplies are covered as durable medical equipment (DME) for all people with Medicare Part B who have diabetes, (even if these members do not use insulin).
Diabetic Supplies Costs
For the Diabetic Supplies, you will pay 20% of the Medicare-approved amount after the yearly Part B deductible ($183 in 2018).
Self-Testing Diabetic Supplies:
- Blood sugar monitors
- Blood sugar test strips
- Lancet devices and lancets
The amount of supplies that are covered may vary (this depends on if you are insulin dependent).
If your doctor says it’s medically necessary, Medicare will allow you to get additional test strips and lancets. Medically Necessary signifies that services or supplies are needed for the diagnosis or treatment of your medical condition and that the services have met accepted standards of medical practice.
What do You Need from Your Doctor to Get the Supplies Covered?
Medicare will only cover your blood sugar self-testing equipment and supplies if you get a prescription from your doctor. The prescription should include:
- Whether you have diabetes
- What kind of blood sugar monitor you need and why you need it
- Whether you use insulin and how often you should test your blood sugar
- How many test strips and lancets you need for one month
Where Can I Get Diabetic Supplies?
You can order and pick up your supplies at your local pharmacy.
You can also order your supplies from a medical equipment supplier. Generally, a “supplier” is any company, person, or agency that gives you a medical item or service (except when you’re an inpatient in a hospital or a skilled nursing facility).
If you get your supplies through a supplier, you must place the order yourself. You’ll need a prescription from your doctor to place your order, but your doctor can’t order the supplies for you.
More Information on Medicare Coverage
Medicare doesn’t cover insulin when it is self-administered or injectable. However, the insulin is generally covered under Medicare Part D (prescription drug plan).[JM1]
Insulin can also be covered under Medicare Part B if it is administered through a durable medical insulin pump.
Finally, it’s important to remember that certain private insurance plans could help you offset these costs for Part D and Part B coverages.
Are you looking for additional information or have specific questions about Diabetic supplies that are provided by Medicare? Contact us for assistance.