Call to speak to a Licensed Insurance Agent
Seniors are at higher risk of developing diabetes, especially Type 2 diabetes. And according to the World Health Organization, adults with diabetes are more vulnerable to experiencing heart attacks and strokes. The good news is that treatment and supplies for diabetes are improving with innovations like continuous glucose monitors or CGMs.
So a common question many people have is, “does Medicare cover diabetic supplies?” In this article, we answer that question in clear, plain English. You will also find the average costs of diabetic supplies and other helpful info.
Does Medicare Cover Diabetic Supplies?
The short answer is yes; Medicare will cover the cost of diabetic supplies. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your diabetic supplies.
Original Medicare (Medicare Part A and Part B) provides coverage for diabetic supplies. Aside from outpatient treatment and operations for diabetes, Medicare Part B also provides coverage for certain diabetic supplies as well as outpatient screenings and even education.
Medicare Part B provides coverage for the following diabetic supplies:
- Supplies for checking your blood sugar such as CGMs, blood glucose test strips, and lancets
- Insulin pump along with the insulin that will be used
- 2 preventive diabetes screenings per year
- Foot exams every 6 months
- Durable medical equipment such as shoe inserts and special shoes
- Diabetic-related eye tests such as glaucoma tests, macular degeneration tests, and cataract tests
- Diabetic education to manage diabetes
- Medical nutrition therapy
However, for many of these supplies and services to be covered by Medicare Part B, you will usually need the following:
- To be diagnosed with diabetes
- A prescription from your healthcare provider for diabetic supplies such as CGMs
- A prescription from your healthcare provider for DME such as diabetic shoes
- How frequently you test your blood sugar level
- Amount of test strips and lancets you need
Most of the time Medicare Part B covers 80 percent of the costs of these supplies and services. You will pay for the remaining 20 percent.
Part C Coverage for Diabetic Supplies
Medicare Advantage plans (Medicare Part C) also provide coverage for diabetic supplies stated above. They cover everything Original Medicare covers, as well as some additional benefits. However, exactly what it covers and your out-of-pocket costs will vary depending on the specifics of your plan.
Part D Coverage for Diabetic Supplies
Medicare Part D also provides coverage for medications for diabetes, as well as the supplies that you need to administer some medications such as insulin injections. Medicare Part D covers some diabetic supplies such as syringes, alcohol swabs, gauze, and insulin inhaler devices.
Part D also provides coverage for the tubeless type of insulin pump as Medicare Part B does not cover them.
How Much Do Diabetic Supplies Cost?
Continuous glucose monitors can cost between $40 and $300 per sensor, along with the cost of the transmitter. Insulin pumps usually cost around $6,000.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover Gender Reassignment Surgery?