What Does Medicare Cover for Diabetes?
If you have diabetes or may be at risk for it, you should know that Medicare covers:
- Diabetes tests
- Services that help you manage your diabetes
- Drugs and supplies you need for diabetes
Medicare Part B covers blood glucose testing and any other supplies you may need, as well as medical and educational services. Medicare Part D covers medication and supplies for injecting or inhaling insulin. (source)
What Does Medicare Not Cover for Diabetes?
While Medicare offers a lot of coverage to help you manage your condition, it doesn’t cover everything.
Medicare does not cover:
- Eye exams for glasses, as diabetes may cause eye damage.
- Routine physical exams from your doctor.
- Weight-loss programs.
Medicare Part B Coverage
For diabetes, Medicare Part B covers:
- Eye tests for glaucoma
- Blood glucose testing supplies and equipment
- Therapeutic shoes or inserts
- Insult pumps
- Foot exams and treatment for diabetes-related nerve damage
- Diabetes self-management training
- Hemoglobin tests to monitor blood sugar levels
- Medical nutrition therapy, including diet and lifestyle counseling
Medicare Part D Coverage
For diabetes, Medicare Part D covers:
- Inhaled insulin
- Medications to help manage blood glucose levels
- Supplies for taking insulin via injection (syringes, needles, alcohol swabs, gauze, etc.)
- Insulin taken by injection
The Cost of Diabetic Supplies & Services That Medicare Covers
Medicare generally covers 80% of the cost of your diabetic supplies and services, while you pay 20% of the Medicare-approved amount for diabetes services and supplies covered by Part B after your yearly deductible is met (also referred to as coinsurance). Some services such as medical nutrition therapy and blood tests may be provided to you at no additional cost.
- Diabetes medications. Part D covers drugs to maintain blood sugar levels, and your Part D coinsurance or deductible may also apply.
- Diabetes screening tests. Part B covers screenings if your doctor determines you’re at risk for diabetes with no coinsurance required.
- Diabetes prevention program. Part B covers Medicare’s Diabetes Prevention Program to help prevent diabetes, and you pay nothing if you’re eligible.
- Diabetes self-management. Part B covers diabetes self-management training for people at risk of diabetes or those recently diagnosed. You pay 20% of the Medicare-approved amount after the yearly deductible.
- Equipment and supplies. Part B covers home blood sugar monitors and supplies you use with the equipment. You pay 20% of the Medicare-approved amount after the yearly Part B deductible.
- Flu and pneumococcal shots. If your doctor accepts the assignment, you pay nothing for your flu shot or pneumococcal shot.
- Foot exams and treatment. For people with loss of protective sensation in the foot due to diabetes, Part B covers 80% of the cost after the yearly deductible.
- Glaucoma tests. Part B covers 80% of the Medicare-approved cost of glaucoma testing every 12 months if you’re at high risk.
- Insulin. Part D covers insulin not administered with an insulin pump, and your coinsurance or copayment Part D deductible may also apply.
Need Help With Your Medicare Options?
When it comes to understanding the healthcare market and which coverage plan is best for your needs, CoverageHaven is your go-to site for information, expertise, and customer support.
CoverageHaven looks beyond the cost of policies. Why? Because we know that not all policies are created equal. We make the process of finding insurance that suits your needs simple. Start your healthcare journey today – it’s never too late to make sure you’re covered.