According to the Centers for Disease Control (CDC), there are ~29m people in the U.S. (about 1 in 11) that has diabetes. Check out the entire CDC Diabetes infographic here.
For Diabetics going on or already on Medicare, confusion is common. How do I pay for my needles & testing strips? What about the insulin? Is my pump covered? These are just a small sampling of questions that we hear often related to Diabetes & Medicare. Some responses to the FAQs are below.
Are my blood testing equipment & supplies covered by Medicare?
Testing Strips, Monitors, Lancet Devices & lancets are covered by Medicare Part B. This is good news for individuals who have original Medicare with a decent Medicare Supplement (e.g. Plan F or G) since Medicare will pay 80% of the cost and the Supplement will pay the other 20%.
What about my insulin?
Medicare drug plans (Part D) cover injectable insulin not used with a pump. Insulin can be very expensive and will most likely result in reaching the Part D donut hole (aka Coverage gap) of Medicare. Find out more about Part D and the Donut hole.
What if I take Metformin (or a similar drug) instead of insulin?
These drugs are generally covered under Part D. You want to make sure you pick the correct Part D plan when you initially enroll in Part D, and each year during your Open Enrollment (Oct 15 – Dec 7). More information and a short video about the Part D RX analysis can be found here.
As a general rule, insulin pumps are not covered by Medicare. However, if a doctor provides a prescription indicating the insulin pump is medically necessary, then Part B (and a Medicare Supplement) will cover both the insulin pump and the insulin.
Read this: Medicare's Coverage of Diabetes Supplies & Services
These are just a few of the FAQs we hear related to diabetes. If you are Diabetic or interested in learning more, you should definitely read through the Medicare’s Coverage of Diabetes Supplies & Services created by CMS (Center for Medicare & Medicare Services).