Does Medicare Cover Diabetic Supplies?

Does Medicare cover Diabetic supplies? A Medicare Advantage plan can help you get some of the medications and supplies you need. Call our licensed insurance agents at (800) 950-0608 to learn more about Medicare Advantage plan options in your area.

Will Medicare Cover the Cost of My Diabetic Supplies?

If you have Type 1 or Type 2 Diabetes and you’re enrolled in Medicare, it’s important to know what types of diabetic supplies Medicare will cover. As diabetic supplies are necessary to help you keep your condition under control, you should be aware of what each plan of Medicare can help you with in terms of obtaining what you need. In this article, we’ll discuss the diabetic supplies covered by Medicare.

What Brand of Diabetic Supplies are Covered by Medicare?

When it comes to Medicare-covered diabetic supplies, the brand isn’t 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 (Part C) 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.

Does Medicare Part B Pay for Diabetic Supplies?

The answer is yes, Medicare Part B will pay for most diabetic supplies. Below, you’ll find you’ll find all of the common diabetes maintenance and diabetic testing supplies Medicare Part B will cover:

• Test strips
• Lancets for glucose testing
• Blood sugar monitors
• Insulin pumps
• Medical footwear

While Part B does not cover most prescription drug costs, including those for diabetic medications, it will sometimes cover insulin needed for insulin pumps. In order for Medicare Part B to cover the insulin required for the pump (and sometimes the pump itself), you’ll have to meet certain conditions. 

There are certain diabetic supplies Medicare Part B will not cover. The diabetic supplies that Medicare Part B does not cover include:

• Insulin pens
• Syringes
• Needles
• Alcohol swabs
• Gauze

Will Medicare Advantage or a Prescription Drug Plan Cover the Supplies that Part B Doesn’t?

What a Medicare Advantage or Prescription Drug Coverage plan does or does not cover depends on three specific things:

• What your plan is willing to cover.
• Whether or not your pharmacy or supplier participates in Medicare assignment.
• Whether or not your needs qualify for Medicare diabetic supplies coverage.

To have diabetic supplies covered by any Medicare plan, you will first need your doctor to write prescriptions that cover the following:

• That you have received a diagnosis for diabetes.
• The types of special devices or monitors you need, and why you need them.
• If you require special shoes, a podiatrist or other foot specialist must explain why you need them and provide a prescription.
• How often you need to test your blood sugar levels.
• The number of test strips and lancets that you need*.

*If you do not use insulin, Part B will usually pay for 100 strips and lancets every 3 months.

In order for Medicare to continue covering your supplies, you’ll need new prescriptions each year from your doctor. If you monitor your blood sugar more often than before, you’ll need to have your supply limits increased.

You’ll also need to get your diabetic supplies from a Medicare-approved provider before Medicare will cover them. Medicare-approved providers accept Medicare assignment, which means that they accept Medicare-set payment rates. If you use a provider, such as a pharmacy or supply company, that does not accept Medicare assignment, then you will be responsible for all costs for your diabetic supplies.

How Do I Know Which Diabetic Supplies My Medicare Advantage/Prescription Drug Coverage Plan Will Cover?

Knowing which types of diabetic supplies that your Medicare plan will cover is crucial. In order to learn which diabetic supplies and diabetic testing supplies Medicare covers under your Part C or Part D plan, you’ll need to do any of the following:

• Call your insurance provider to learn what types of diabetic supplies are covered under your Part C or Part D plan.
• Read the coverage materials that you received when you purchased your plan.
• Visit your insurance provider’s website and sign in to their beneficiary portal to find out which diabetic supplies are covered by your plan.

Some Medicare Advantage insurance providers offer what are known as Special Needs Plans, or SNPs. SNPs provide additional or specific services for beneficiaries with chronic conditions, including diabetes. As always, the coverage may vary, but a diabetes SNP can offer additional benefits that Original Medicare or other Advantage plans may not provide, including assistance with supplies.

When it comes to obtaining the supplies you need to help keep your diabetes under control, never leave what your plan covers up to guesswork. The diabetic supplies that you need may be covered by your Medicare plan. All it takes is a simple phone call, a few moments to read your plan booklet, or the click of a mouse to find out.