Traditional Medicare covers the following for everyone with diabetes who has Part B, whether they use insulin or not. Medicare will cover 80% of the Medicare-approved amount after the patient has paid the yearly Part B deductible. The patient is responsible for the remaining 20% of the cost after paying the annual deductible. Many private Medicare supplement plans will cover the patient's 20% co-payment. Some even will cover the annual Part B deductible. Check with your plan:.
• Blood sugar monitors
• Blood sugar test strips
• Lancet devices and lancets
• Glucose control solutions for checking the accuracy of testing equipment and test strips
• For those who use an insulin pump. Medicare Part B covers both the pump and the insulin under Part B.
The amount of supplies covered does depend on whether the patient does or does not use insulin. Those who use insulin should be covered for up to 100 test strips and lancets every
month, and one lancet device every 6 months. Those who do not use insulin should be covered for up to 100 test strips and lancets every 3 months, and one lancet device every 6 months.
If the patient's physician states in writing that it is "medically necessary," Medicare will often allow coverage for additional test strips and lancets.
Supplies used for administering insulin are no longer included under traditional Medicare Part B insurance. Since the advent of private Medicare Part D drug plans, the following supplies have been covered by these plans. Each Part D plan will offer their own unique coverage for insulin, as well as the following supplies for its administration. Co-insurance, co-payments and deductibles may apply, depending on the plan:
• alcohol swabs
• inhaled insulin devices
Anyone who wants to have their testing and injecting supplies covered by Medicare will have to have a very detailed prescription from their doctor. Some pharmacies have a form for the doctor to complete so that no mandatory item is missed. The doctor's prescription must explicitly state:
• Whether you have diabetes
• What kind of blood sugar monitor you need and why you need it (If you need a special monitor because of vision problems, your doctor must explain that.)
• Whether you use insulin
• How often you should test your blood sugar
• How many test strips and lancets you need for 1 month
Medicare requires a new detailed prescription from the doctor for lancets and test strips every 12 months.
You must get supplies from a pharmacy or supplier that is enrolled in Medicare. If you use a pharmacy or supplier that does not participate in Medicare, your supplies will not be covered.
For some obscure reason a patient is not permitted to submit a claim to Medicare for blood sugar (glucose) monitor test strips. The pharmacy or test strip supplier must submit these claims. If the pharmacy or supplier accepts assignment, Medicare will pay the pharmacy or supplier directly. the patient should only be required to pay the coinsurance amount.