Millions of Americans live with diabetes daily, but most Medicare beneficiaries don’t fully grasp what is or is not covered in regards to insulin and diabetic supplies. The confusion is understandable. For example, Medicare Part B (medical/outpatient) doesn’t cover all the diabetic supplies one might need. Some of that goes through Medicare Part D (prescription). And what you pay for insulin and diabetic supplies can vary, based on the medical and prescription drug coverage you have.
Let’s break down which items run through Part B and Part D below:
Diabetic items covered under Part B (medical):
Insulin (only if administered through an insulin pump)*
Insulin pump
Blood sugar test strips
Blood sugar monitors and continuous glucose monitors (CGM)
Lancets and lancet devices
If you have Original Medicare, you need to first verify that the durable medical equipment (DME) supplier you’re using accepts Medicare to avoid added costs. Medicare will apply its part and then your Medicare Supplement (Medigap) plan will pay as secondary.
If you have a Medicare Advantage plan, you need to verify that the durable medical equipment (DME) supplier you’re using is IN-network with your HMO or PPO plan to avoid added costs. Usually you’ll owe somewhere between 0-20%, depending on the plan.
Diabetic items covered under Part D (drug):
Insulin pens*
Needles
Syringes
Alcohol swabs
Gauze
* The cost for insulin through Part B is limited to $35 for a 30-day supply.
The cost for insulin through Part D is limited to $35 for a 30-day supply when the insulin is covered on the plan’s formulary list of drugs.
Reference Links
www.medicare.gov
Insulin & Diabetic Supplies
Blood Sugar Test Strips
Blood Sugar Monitors
Lancets
Neither Medicare Mindset LLC nor its agents are connected with the Federal Medicare program.
