{"id":53633,"date":"2022-09-20T14:08:16","date_gmt":"2022-09-20T18:08:16","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53633"},"modified":"2025-12-31T15:12:08","modified_gmt":"2025-12-31T20:12:08","slug":"what-does-medicare-cover-for-diabetics","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-does-medicare-cover-for-diabetics\/","title":{"rendered":"What does Medicare cover for diabetics?"},"content":{"rendered":"

Diabetes affects approximately <\/span>11%<\/span><\/a> of the U.S. adult population. Of the Americans diagnosed with diabetes, 11.5 million are older than 65. An additional 2.9 million adults older than 65 have undiagnosed diabetes, and another 24.2 million adults older than 65 have prediabetes. Fortunately, <\/span>Medicare covers many aspects of diabetes care, including preventive services, doctor visits, labs, treatment and medical supplies, and wound care. <\/span>Use this guide to understand what components of diabetes care\u00a0each part of Medicare<\/a> covers so you can choose the best plan during the next enrollment period.<\/p>\n

What does Medicare cover for diabetics?<\/span><\/h2>\n

Medicare Part A<\/span><\/h3>\n

If you receive diabetes treatment or care at the hospital, your coverage will fall under Medicare Part A.<\/span><\/p>\n

Medicare Part B<\/span><\/h3>\n

If you receive diabetes treatment or care at your healthcare provider’s office, your coverage will fall under Medicare Part B.<\/span><\/p>\n

If you\u2019re prescribed any diabetes testing supplies that are considered Durable Medical Equipment (DME), your coverage will fall under Medicare Part B. Medicare Part B normally will cover 80% of your DME after you meet your Part B deductible. Other factors that may impact the cost of DME are whether you buy or rent the equipment and whether the provider accepts the assignment.\u00a0<\/span><\/p>\n

RELATED: <\/b>Does Medicare Part B cover prescriptions?<\/b><\/a><\/p>\n

Medigap<\/span><\/h3>\n

If you have a Medicare supplement plan, it will cover most, if not all, of your cost-sharing under Medicare Parts A and B.<\/span><\/p>\n

Medicare Advantage (Part C)<\/span><\/h3>\n

Medicare Advantage covers everything under Parts A and B and typically includes prescription drug coverage. However, cost-sharing varies, and your network of providers will be more limited than with Original Medicare.<\/span><\/p>\n

Medicare Part D<\/span><\/h3>\n

Any prescription medications you\u2019re prescribed by your healthcare provider to treat diabetes will be covered under your Medicare Part D plan.\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

What\u2019s covered?<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Benefit<\/b><\/td>\nWhich part(s) of Medicare offer coverage?<\/b><\/td>\nWhat Medicare covers<\/b><\/td>\nWhat you pay<\/b><\/td>\n<\/tr>\n
Specialist visits<\/span><\/td>\nPart B covers outpatient specialist visits if medically necessary.<\/span><\/td>\nMedicare will cover 80% of the Medicare-approved amount.<\/span><\/td>\n20% of the Medicare-approved amount (after the annual Part B deductible). If you have a supplement policy, the cost may be less.\u00a0<\/span><\/td>\n<\/tr>\n
Screenings and labs<\/span><\/td>\nPart B covers diabetes screenings, labs, and tests. If you have risk factors for diabetes, you may be eligible to receive two diabetes screenings per year. If you have diabetes, Medicare also covers <\/span>glaucoma tests<\/span><\/a> once every 12 months.<\/span><\/td>\nMedicare will cover 100% of the Medicare-approved amount for screenings at participating providers if you meet the eligibility requirements. They will cover 80% of the Medicare-approved labs.\u00a0<\/span><\/td>\n20% of the Medicare-approved amount (after the annual Part B deductible). If you have a supplement policy, the cost may be less.\u00a0<\/span><\/td>\n<\/tr>\n
Diabetes supplies<\/span><\/a><\/td>\nPart B covers DME, including glucose monitors, blood sugar test strips, syringes, and lancets.\u00a0<\/span><\/td>\nMedicare will cover 80% of the Medicare-approved amount. There may be limits on how much or how often you get these supplies.<\/span><\/td>\n20% of the Medicare-approved amount (after the annual Part B deductible).<\/span><\/td>\n<\/tr>\n
Diabetes medications<\/span><\/a><\/td>\nPart D covers diabetes drugs to maintain blood sugar at a normal level.<\/span><\/td>\nThe cost of the medications minus the Part D annual deductible.<\/span><\/td>\nThe Part D deductible plus any coinsurance or copays.\u00a0<\/span><\/td>\n<\/tr>\n
Foot exams, treatment, and diabetes shoes<\/span><\/a><\/td>\nPart B will cover the exam at your podiatrist, the fitting, and the shoes.<\/span><\/td>\nMedicare will cover 80% of the Medicare-approved amount. There may be limits on how much or how often you get these supplies.<\/span><\/td>\n20% of the Medicare-approved amount (after the annual Part B deductible).<\/span><\/td>\n<\/tr>\n
Insulin and insulin devices<\/span><\/a><\/td>\nPart D covers insulin that isn\u2019t administered with an insulin pump. Part B may cover an insulin pump as DME.\u00a0<\/span><\/td>\nThe cost of the insulin minus the Part D annual deductible.<\/span><\/td>\nThe Part D deductible plus any coinsurance or copays.\u00a0<\/span><\/td>\n<\/tr>\n
Wound care<\/span><\/a><\/td>\nPart B will cover wound care received at an outpatient facility.<\/span><\/td>\nMedicare Part B will cover 80% of the Medicare-approved amount. There may be limits on how much or how often you get these supplies.<\/span><\/td>\n20% of the Medicare-approved amount (after the annual Part B deductible).<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

What\u2019s not covered?<\/span><\/h3>\n

Medicare coverage of diabetes supplies and services does <\/span>not<\/span><\/i> include e<\/span>ye exams for glasses.<\/p>\n

RELATED: <\/b>What you need to know about diabetic eye disease<\/b><\/a><\/p>\n

Medicare diabetes coverage FAQs<\/span><\/h2>\n

Does Medicare cover diabetes under 65?<\/span><\/h3>\n

Yes, if you\u2019re younger than 65 and eligible for Medicare due to a disability, Medicare will cover diabetes.<\/span><\/p>\n

Which items are covered under Medicare Part B for beneficiaries with diabetes?<\/span><\/h3>\n

Medicare Part B covers any outpatient exams, tests, surgeries, treatments, or DME for beneficiaries with diabetes.<\/span><\/p>\n

Does Medicare cover diabetes medicine?<\/span><\/h3>\n

Yes, Medicare Advantage plans with prescription drug coverage and Medicare Part D will cover diabetes medication prescribed by your healthcare provider that you pick up at your local pharmacy if the medication is included in the <\/span>plan’s formulary<\/span><\/a>. Any medications given in an outpatient setting will be covered under Part B.<\/span><\/p>\n

Does Medicare cover insulin for diabetes?<\/span><\/h3>\n

Yes, Medicare Part B will pay 80% of the cost of the insulin given in an outpatient setting and the insulin pump as DME. For injectable insulin given at home, coverage will fall under Medicare Part D.<\/span><\/p>\n

How often does Medicare pay for an A1C test?<\/span><\/h3>\n

A <\/span>hemoglobin A1C test<\/span><\/a> is a lab test that measures how well your blood sugar has been controlled over a given time period. If you have diabetes, Medicare Part B covers this test every 90 days.<\/span><\/p>\n

What diabetes supplies are covered by Medicare Part B?<\/span><\/h3>\n