{"id":47489,"date":"2021-11-20T14:38:31","date_gmt":"2021-11-20T19:38:31","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=47489"},"modified":"2024-09-30T18:56:13","modified_gmt":"2024-09-30T22:56:13","slug":"diabetic-supplies-medicare","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/diabetic-supplies-medicare\/","title":{"rendered":"Does Medicare cover diabetic supplies?"},"content":{"rendered":"

One in three Medicare beneficiaries has diabetes, according to the <\/span>Centers for Medicare & Medicaid Services<\/span><\/a>. Older individuals are also more prone to diabetes as they age, according to the <\/span>American Diabetes Association,<\/span><\/a> due to increasing insulin resistance and impaired pancreatic function.<\/span><\/p>\n

With such a large portion of Medicare recipients with diabetic needs, is there adequate Medicare coverage for diabetic supplies? According to a <\/span>SingleCare survey<\/span><\/a>, 20% of survey respondents reported that Medicare or Medicaid completely covers their diabetes care. An additional 10% reported that Medicare or Medicaid partially covers their diabetes care. Although any coverage is helpful when it comes to expensive medications and diabetic testing supplies, many Medicare consumers are still looking for ways to save.<\/span><\/p>\n

Which Medicare plans cover diabetic supplies?<\/span><\/h2>\n

There are four parts of Medicare<\/span><\/a>. All parts of Medicare can be advantageous to consumers with diabetes. Medicare Part B and D or a Medicare Advantage plan with prescription drug coverage are the most beneficial to people with diabetes. Here is a complete breakdown of what each plan covers in relation to diabetes care:<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Diabetes supply coverage by Medicare plan<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nDiabetic supplies<\/b><\/td>\nRestrictions<\/b><\/td>\n<\/tr>\n
Part A<\/b><\/td>\nNot covered<\/span><\/td>\n<\/td>\n<\/tr>\n
Part B<\/b><\/td>\nDiabetes screening tests<\/span><\/td>\nEligible patients can have an annual diabetes screening test each year.<\/span><\/td>\n<\/tr>\n
Medicare diabetes prevention program<\/span><\/td>\nNo restrictions<\/span><\/td>\n<\/tr>\n
Diabetes self-management training<\/span><\/td>\nFor Medicare coverage, a healthcare provider has to order it, and an accredited program or individual must provide the service.\u00a0<\/span><\/td>\n<\/tr>\n
Diabetes equipment and supplies<\/span><\/td>\nThere may be limits based on the frequency and amount of supplies.<\/span><\/td>\n<\/tr>\n
Foot exams and treatment\u00a0<\/span><\/td>\nYou must have diabetic peripheral neuropathy (nerve damage) and loss of protective sensation. You can have an exam every six months, as long as you have not been to a foot care professional between visits for other reasons.<\/span><\/td>\n<\/tr>\n
Insulin pumps<\/span><\/td>\nIf you meet certain conditions, external insulin pumps and the insulin they use may be covered.<\/span><\/td>\n<\/tr>\n
Medicare nutrition treatment<\/span><\/td>\nA provider needs to refer you for these services.<\/span><\/td>\n<\/tr>\n
Therapeutic shoes or inserts<\/span><\/td>\nYou must have diabetes and severe diabetic foot disease.<\/span><\/td>\n<\/tr>\n
Part C<\/b><\/td>\nIncludes everything covered by Parts A and B and typically Part D<\/span><\/td>\n<\/td>\n<\/tr>\n
Part D<\/b><\/td>\nAnti-diabetic drugs<\/span><\/td>\nSee your plan\u2019s formulary for restrictions<\/span><\/td>\n<\/tr>\n
Diabetes supplies<\/span><\/td>\nThere may be limits based on the frequency and amount of supplies.<\/span><\/td>\n<\/tr>\n
Insulin<\/span><\/td>\nInsulin is covered under Part D if it is not administered via a pump.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Source: <\/span><\/i>Centers for Medicare & Medicaid Services<\/span><\/i><\/a><\/p>\n

Which diabetic supplies are covered by Medicare?<\/span><\/h2>\n

For those with diabetes, Medicare Part B covers three main areas of diabetic supplies: blood sugar self-testing equipment and supplies, insulin pumps, and therapeutic shoes or inserts. For these areas, Medicare typically covers 80% of the visit, and you will pay 20% if you do not have coinsurance. These costs can also go toward the Part B deductible.<\/span><\/p>\n

Medicare Part B also covers certain diabetic screenings and services.<\/span><\/p>\n

\u201cIf you have an insulin pump, Medicare Part B covers the pump as well as the insulin under durable medical equipment instead of as medicine under Part D,\u201d explains <\/span>Lindsey Hudson<\/span><\/a>, APRN, NP-C, and certified diabetes care and education specialist working in Charleston, South Carolina and member of the <\/span>SingleCare Medical Board<\/span><\/a>.<\/span><\/p>\n

For the supplies, screenings, and services below, note that Medicare consumers may have to pay coinsurance, copays, and\/or deductibles, depending on their plan.<\/span><\/p>\n

1. Blood sugar self-testing supplies<\/span><\/h3>\n

With Medicare Part B, blood sugar self-testing equipment and supplies are covered under durable medical equipment (sometimes called DME), even if you do not require insulin. These supplies include:<\/span><\/p>\n