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Did you know that more than 34 million people in the United States have diabetes?
To manage this condition, most people end up paying twice the amount of medical expenses as those without diabetes.
There are a lot of services, medications, tests and more someone with diabetes will need. One common one is the needles necessary for insulin injections.
This leads to a question that many with diabetes ask, “Does Medicare cover needles For diabetics?”
In this article, we answer the question in clear, plain English. You will also find the average costs of treatment for needles for diabetics and other helpful info.
Does Medicare Cover Needles For Diabetics?
The short answer is no. In most cases, Medicare will not cover the cost of needles for people with diabetes. However, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your treatment for needles for people with diabetes.
Original Medicare Coverage of Insulin Needles
Original Medicare (including Medicare Part A and Part B) does not provide coverage for needles for people with diabetes. So, that means you will have to pay 100 percent for your needles for diabetes.
However, this plan can provide coverage for parts of the treatment for diabetes if it is considered medically necessary. Your healthcare provider must first order the operation for Original Medicare to provide coverage.
When Does Part A Cover Diabetes Treatment?
Coverage for treatment is provided by Medicare Part A if your treatment for diabetes takes place in an inpatient setting. Medicare Part A will cover 100 percent of the costs of hospital stays for up to 60 days.
When Does Part B Cover Diabetes Treatment?
On the other hand, coverage is provided by Medicare Part B if it occurs in an outpatient setting. This is often the case, because diabetes needs to be managed on a daily basis.
Part B also provides coverage for certain diabetic supplies as well as outpatient screenings and even education.
What does this include? Often it covers the following diabetic supplies:
- Supplies for testing and checking blood sugar. This can be Continuous Glucose Monitors (CGMs), blood glucose test strips, and lancets
- Insulin pump (only the tubed type along with the insulin)
- Two preventive diabetes screenings per year
- Foot exams every six 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
Once approved, Medicare Part B covers 80 percent of the costs of treatment for diabetes. You will pay for the remaining 20 percent.
As you can see this does not include needles to inject the insulin. Do any plans cover it?
Medicare Advantage Coverage of Needles for Diabetics
In fact, some Medicare Advantage plans (Medicare Part C) provide coverage for insulin needles.
Generally, Medicare Advantage plans cover everything Original Medicare covers and some additional benefits. These are private insurance companies, that cover your prescribed medications.
Insulin needles for diabetics are often covered by Part D plans as well as the Part C plans that include prescription drug coverage.
Additionally, Part D covers other diabetic supplies such as syringes, alcohol swabs, gauze, and insulin inhaler devices.
How Much Do Needles Cost?
Insulin syringes averagely cost $15 to $20 for a box of 100, however, coverage and out-of-pocket costs will vary depending on where you buy them and the brands of syringes you get.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always 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 reading glasses?