Does Medicare Cover Insulin Pumps?

Insulin pumps make the intake of insulin much easier for those with diabetes. They also have other benefits such as pain reduction and a lesser chance of suffering from a hypoglycemia episode.

Though they have life-changing benefits, insulin pumps along with their supplies can be very expensive and not everyone who needs one can easily afford it.

So a common question many people have is, “does Medicare cover insulin pumps?” In this article, we answer that question in clear, plain English. You will also find the average costs of insulin pumps and other helpful info.

Does Medicare Cover Insulin Pumps?

The short answer is yes; Medicare will cover the cost of insulin pumps. 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 insulin pump.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for dementia care. Coverage for insulin pumps is provided by Medicare Part B.

However, Medicare Part B only covers a certain type of insulin pump which is the tubed insulin pump. Tubed insulin pumps are considered by Medicare Part B as Durable Medical Equipment, or DME, which Medicare Part B typically covers.

However, for Medicare Part B to provide coverage for tubed insulin pumps, there are some requirements that have to be followed. Part B will provide coverage if you:

Are using insulin to manage your diabetes
Require frequent adjustments and dosages in your insulin regimen
Need to check your blood sugar levels four times a day

Medicare Part B also provides coverage for the insulin that the DME uses. Medicare Part B covers 80 percent of the costs of your tubed insulin pumps. You will pay for the remaining 20 percent.

Part D Coverage for Insulin Pumps

On the other hand, Medicare Part D plans may provide coverage for tubeless insulin pumps. Medicare Part D typically provides coverage for prescription drugs. Medicare Part D is similar to Medicare Part C as it is made up of plans that different insurance companies offer. Many Medicare Part C plans include Part D coverage.

Some Medicare Part D plans provide coverage for tubeless insulin pumps, but not all of them do. If you need an insulin pump, be sure to shop around for a plan that covers them.

How Much Does An Insulin Pump Cost?

Most of the time, insulin pumps cost around $6,000. You will also pay for an additional $3,000 to $6,000 every year for the replacement of its supplies. The exact cost of an insulin pump will depend on the product’s size, features, brand, software, pump size, and type.

What Is An Insulin Pump And Its Advantages?

An insulin pump is a device that delivers insulin to your body 24/7. One great advantage of having an insulin pump is it releases insulin similar to how our bodies naturally do so. Compared to insulin injections, an insulin pump is more accurate in administering insulin in our bodies.

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.