Does Medicare Cover Diabetic Supplies?
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Medicare covers diabetic supplies, but there may be limits on the quantity you can get for certain items and how frequently you can get them.
What diabetic supplies does Medicare Part B cover?
Medicare Part B (Original Medicare’s medical insurance portion) pays 80% of the cost of covered supplies, once you’ve met your annual deductible amount — and whether or not you use insulin to manage your diabetes. These covered supplies include:
Home blood sugar (glucose) monitors.
Glucose control solutions and test strips to check your monitor’s accuracy.
Blood sugar test strips.
Lancets.
Lancet devices.
Therapeutic continuous glucose monitors and supplies (if you meet certain conditions).
Durable insulin pumps and the insulin the pump uses (if you meet certain conditions).
There are some potential limits on these supplies to be aware of:
If you don’t use insulin, you may be limited to 100 lancets and 100 blood sugar test strips every three months.
If you use insulin, you may be limited to 300 lancets and 300 blood sugar test strips every three months.
If you need more lancets and strips than this limit allows to maintain your health, you'll need to get your doctor to document that the additional quantity you use is medically necessary. Medicare may then approve your additional supplies; however, you may need to keep a written record of how often you test your blood sugar.
Also, if you're experiencing severe diabetic foot disease, Medicare Part B covers 80% of the cost of therapeutic shoes and inserts once you’ve met the Part B deductible.
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What diabetic supplies does Medicare Part D cover?
Medicare Part D (Medicare’s drug insurance) covers some diabetic supplies that are used to take insulin, including:
Needles.
Syringes.
Gauze.
Alcohol swabs.
Inhaled insulin devices.
Because Medicare Part D is offered through private insurance companies, your responsibility for any deductibles, coinsurance or copayments may vary depending on your insurer and your specific plan.
What about Medicare Advantage?
All Medicare Advantage plans are required to provide at least as much coverage as Original Medicare, so any Medicare Advantage plan will cover all the diabetic supplies that Original Medicare does — and some plans may offer additional coverage. Because Medicare Advantage is offered through private insurance companies, however, these plans may each have different rules regarding premiums, copays, coinsurance, deductibles and provider networks.
What do diabetic supplies cost without insurance?
Some diabetic supplies are quite costly, and even the cost of less expensive items can add up over time without insurance. For example:
Blood glucose monitors can run about $15 to $175 or more, depending on the brand and features.
Lancets are typically sold in boxes of 100 to 300 and can cost from $6 to $10 a box.
Testing strips can run up to $46 for a 100-count box.
Insulin pumps can cost about $4,500, with related supplies adding more than $1,500 annually to that price.
Syringes average around $24 for a box of 100.
Continuous glucose monitors, or CGM, vary from just under $90 to $700 for the transmitter and receiver. A month’s worth of sensors may add a cost of about $130 to $420.
How can I reduce my out-of-pocket costs for diabetic supplies?
If you have Medicare and want to reduce your out-of-pocket costs for diabetic supplies, consider purchasing a Medigap (supplemental) policy, which kicks in to cover the coinsurance you owe for covered expenses. Additionally:
Some manufacturers offer free and low-cost diabetic supplies to qualifying individuals.
The Patient Advocate Foundation offers a state-by-state directory to help people find assistance with health care expenses. It also has a copay relief program that provides direct financial assistance to help with copays, coinsurance and deductibles.
The National Council on Aging’s Benefits CheckUp tool helps connect older adults and people with disabilities to programs that may help pay for medical and other expenses.
The Health Resources and Services Administration, or HRSA, offers a tool to help you find a federally qualified health center in your area that may be able to provide free or reduced-cost diabetic supplies.
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