Does Medicare Cover Diabetic Supplies?

While Medicare does cover prescription diabetic supplies, there are restrictions on the number and frequency with which you can purchase them.

Medicare covers diabetic supplies, but there may be limits on the number and frequency with which you can obtain them.

What diabetic supplies does Medicare Part B cover?

Once you've met your annual deductible amount — and whether or not you use insulin to control your diabetes — Medicare Part B (Original Medicare's medical insurance portion) pays 80% of the cost of approved supplies. These supplies are included:

  • Home blood sugar (glucose) monitors.
  • Glucose control solutions and test strips to ensure the accuracy of your monitor.
  • Strips for testing blood sugar.
  • Lancets.
  • Lancet devices.
  • If you satisfy specific criteria, you may be eligible for therapeutic continuous glucose monitors and supplies.
  • Durable insulin pumps and the insulin the pump uses (if you meet certain conditions).

There are various potential supply constraints to be aware of:

  • You may be limited to 100 lancets and 100 blood sugar test strips every three months if you do not use insulin.
  • You may be limited to 300 lancets and 300 blood sugar test strips every three months if you use insulin.

If you require more lancets and strips than this limit allows to preserve your health, you must obtain documentation from your doctor proving that the additional number is medically essential. The additional supplies may subsequently be approved by Medicare; however, you may be required to keep a written record of how frequently you test your blood sugar.

In addition, if you have a severe diabetic foot condition, Medicare Part B covers 80% of the cost of therapeutic shoes and inserts once your Part B deductible has been met.

What diabetic supplies does Medicare Part D cover?

Some diabetic supplies used to take insulin are covered by Medicare Part D (Medicare's prescription insurance), including:

  • Needles.
  • Syringes.
  • Gauze.
  • Alcohol swabs.
  • Inhaled insulin devices.

Because Medicare Part D is provided by commercial insurance companies, your liability for deductibles, coinsurance, and copayments may differ depending on your insurer and plan.

What about Medicare Advantage?

All Medicare Advantage plans are mandated to provide as least as much coverage as Original Medicare, which means that any Medicare Advantage plan will cover all of the diabetic supplies that Original Medicare covers – and some plans may provide more coverage. Because Medicare Advantage is provided by commercial insurance carriers, the rules for premiums, copays, coinsurance, deductibles, and provider networks may fluctuate.

What do diabetic supplies cost without insurance?

Some diabetes supplies are rather pricey, and even less expensive goods can quickly pile up without insurance. As an example:

  • Blood glucose monitors can run about $15 to $175 or more, depending on the brand and features.
  • Lancets are commonly offered in boxes of 100 to 300, with prices ranging from $6 to $10 per box.
  • Testing strips can run up to $46 for a 100-count box.
  • Insulin pumps can cost around $4,500, with related supplies costing more than $1,500 each year.
  • 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 might cost between $130 and $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 provide free or low-cost diabetes supplies to those who qualify.
  • The Patient Advocate Foundation provides a state-by-state database to help consumers discover financial support for medical bills. It also has a cost relief program, which offers direct financial assistance with copays, coinsurance, and deductibles.
  • The Benefits CheckUp tool from the National Council on Aging connects older persons and people with disabilities to programs that may help pay for medical and other expenditures.
  • The Health Resources and Services Administration, or HRSA, provides a tool to assist you in locating a federally certified health facility in your area that may be able to supply free or low-cost diabetic supplies.

For more information about Medicare, go to Medicare.gov or contact 800-MEDICARE (800-633-4227, TTY 877-486-2048).