Medicare Coverage of Diabetic Supplies
Many people are both diabetic and on Medicare. Therefore, they need to understand the Medicare Coverage of Diabetic Supplies. Because there is more than one way to get your Medicare coverage, you need to understand how your diabetic supplies are covered. We will start with the easiest first.
If you are on a Medicare Advantage plan, your supplies should be covered by that plan.
Please be aware; it is always important to compare plans to find the best coverage options to suit your needs.
If you are on original Medicare (Part A & Part B); please see the explanation below of Medicare coverage of diabetic supplies:
Medicare Part B covers self testing of blood sugar equipment and supplies. These items fall under the category, durable medical equipment or DME. This applies even when you do not use insulin.
Here is a list of Self-testing supplies that qualify as DME:
1. Blood sugar monitors
2. Blood sugar test strips
3. Lancets and lancet devices
4. Glucose control solutions that monitor the accuracy of testing equipment as well as test strips
Although diabetic supplies are covered by Medicare Part B weather you use insulin or not, the number of supplies will be reduced for those who do not use insulin. There are exceptions to this. If your doctor provides documentation stating that additional supplies are medically necessary and you meet the other qualifications, Medicare will cover the additional supplies.
Be aware; you should keep a record of when you test yourself. This will help prove that you meet the criteria to qualify for additional testing supplies. In some cases medicare will cover therapeutic, continuous glucose monitors and other related supplies. If you use them instead of blood sugar monitors to help with diabetic treatment decision making; like changes in diet and insulin dose.
Some situations when Medicare will consider coverage of continuous glucose monitor:
When you make adjustments to your insulin dose often, a continuous monitor may be the best choice for you.
If you need to check your insulin levels 4 or more times per day.
You either need to use an insulin pump or receive 3 or more insulin injections per day.
It is always important to visit your doctor regularly to keep your treatment plan up-to-date.
If you need answers to your diabetic supply questions, you can either visit medicare.gov/coverage or call 1-800-633-4227. TTY users can call 1-877-486-2048.
Where do I get my supplies:
This is an important question. When you need to choose where to get your diabetic supplies, you need to ask the pharmacy/supplier these questions:
- Are you enrolled in Medicare?
- Do you accept assignment?
If the answer to either of these questions is no, you should look for another local supplier/pharmacy to get your supplies from in order to receive coverage from Medicare and save yourself some money.
When you can’t find a supplier or pharmacy in your local area; you may need to order your supplies through a mail order company that does accept assignment.
For help finding a supplier; you can either go to Medicare.gov/supplier or call 1-800-633-4227 (TTY users can call 1-877-486-2048).