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What diabetic supplies does Medicare cover?

What diabetic supplies does Medicare cover?

Medicare covers some diabetes supplies, including:

  • blood glucose test strips
  • blood glucose monitor
  • lancet devices and lancets, and
  • glucose control solutions for checking the accuracy of test strips and monitors. See blood glucose monitor coverage under Durable Medicare Equipment for more information.)

There may be limits on how much or how often you get these supplies. Here are some ways you can make sure your Medicare diabetes medical supplies are covered:

  • Only accept supplies you have ordered. Medicare won't pay for supplies you didn't request.
  • Make sure you request your supply refills. Medicare won't pay for supplies sent from the supplier to you automatically.
  • All Medicare-enrolled pharmacies and suppliers must submit claims for diabetic testing supplies. You can't send in the claim yourself.

Medicare doesn't cover insulin (unless used with an insulin pump), insulin pens, syringes, needles, alcohol swabs, gauze, eye exams for glasses, and routine or yearly physical exams. If you use an external insulin pump, insulin and the pump could be covered as durable medical equipment. There may be some limits on covered supplies or how often you get them. Insulin and certain medical supplies used to inject insulin are covered under Medicare prescription drug coverage. Therapeutic Shoes or Inserts: Medicare covers therapeutic shoes or inserts for people with diabetes who have severe diabetic foot disease. The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts. The shoes and inserts must be prescribed by a podiatrist or other qualified doctor and provided by a podiatrist, orthotist, prosthetist, or pedorthist. Medicare helps pay for one pair of therapeutic shoes and inserts per calendar year. Shoe modifications may be substituted for inserts. The fitting of the shoes or inserts is covered in the Medicare payment for the shoes. An order (prescription) must be on file with the supplier. It must be signed and dated by the treating doctor. Make sure your supplier is enrolled in Medicare and has a Medicare supplier number. Suppliers have to meet strict standards to qualify for a Medicare supplier number. Medicare won't pay your claim if your supplier doesn't have a number, even if your supplier is a large chain or department store that sells more than just durable medical equipment (DME). Your Costs in the Original Medicare Plan? You pay 20% of Medicare-approved amounts. You pay 100% for insulin (unless used in a pump), syringes, and needles, unless you have Medicare prescription drug coverage. You may rent or purchase certain diabetic supplies. For more information, you may call 1-800-MEDICARE (1-800-633-4227). If a supplier of DME doesn't accept assignment, there is no limit to what you can be charged. You also may have to pay the entire bill (your share and Medicare's share) at the time you get the DME. Note: Ask if the supplier is a participating supplier in the Medicare program before you get durable medical equipment. If the supplier is a participating supplier, they must accept assignment. If the supplier is enrolled in Medicare but isn't "participating," they have the option to accept assignment. If the supplier isn't enrolled in Medicare, Medicare won't pay your claim.

FAQ_Category: 
Coverage