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.
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:
There are various potential supply constraints to be aware of:
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.
Some diabetic supplies used to take insulin are covered by Medicare Part D (Medicare's prescription insurance), including:
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.
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.
Some diabetes supplies are rather pricey, and even less expensive goods can quickly pile up without insurance. As an example:
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:
For more information about Medicare, go to Medicare.gov or contact 800-MEDICARE (800-633-4227, TTY 877-486-2048).