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Medicare & Diabetes - What's Covered?

7/11/2016

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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.

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www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18011.pdfIs my insulin pump covered?
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.

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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). ​

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  • Home
  • FREE Quotes
  • About YOU
    • Turning 65, Ready to enroll?
    • Working Past Age 65?
    • Already on Medicare, Looking to Save Money?
    • Currently on a Retiree Plan?
  • About Us
  • Products
    • Medicare Supplements & Medicare Advantage >
      • Medicare Supplement - Plan F >
        • Plan F (2022)
        • Plan F (2023)
      • Medicare Supplement - Plan G >
        • Plan G (2022)
        • Plan G (2023)
      • Medicare Supplement - Plan N >
        • Plan N (2022)
        • Plan N (2023)
    • Medicare Part D - Prescription
    • Medicare & Dental
    • International Travel
    • Long-Term Care Insurance
    • Cancer and Heart Attack or Stroke Insurance
    • Medigap Plans
  • Workshops
    • Register for Workshop
    • Watch Workshop Now
  • Carrier Partners
  • Medicare Blog
  • Testimonials
  • Contact Us
  • Become an Agent
  • Areas We Serve
    • Basking Ridge, NJ
    • Livingston NJ
    • Medford, NJ
    • Mountainside, NJ
    • Mount Laurel, NJ
    • Philadelphia, PA
    • Phoenix, AZ
    • Scotch Plains, NJ
    • Scottsdale, AZ
    • Short Hills, NJ
    • Summit, NJ
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    • Washington Township
    • Monroe Township, NJ
  • Medicare FAQs
  • Coffee with Justin
  • Medicare Minute