Medicare & Diabetes - What's Covered?

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.

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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