What Diabetic Supplies Are Covered by Original Medicare?
Original Medicare Part B covers some diabetic supplies, including:
- Blood sugar (glucose) test strips
- Blood glucose monitors, lancet devices, and lancets
- Glucose control solutions for checking the accuracy of test strips and monitors
- Insulin if you are using a medically necessary insulin pump (see below)
- Therapeutic shoes or inserts (see below)
There may be coverage limits on the quantity and frequency you can get these supplies.
Original Medicare Part B does not cover these diabetic supplies:
- Insulin (unless used with an insulin pump)
- Insulin pens, syringes, or needles
- Alcohol swabs or gauze
About insulin coverage
- If you use a medically necessary external insulin pump, the insulin and the pump could be covered as durable medical equipment (DME).
- If you do not use a pump, you pay for all of your insulin costs.
- If you have Medicare prescription drug coverage (Medicare Part D), insulin and certain medical supplies used to inject insulin are covered.
About therapeutic shoes and inserts
Medicare Part B coverage includes therapeutic shoes or inserts for diabetics who have certain conditions — ask the doctor who treats your diabetes if you need them. To make sure these supplies are covered by Medicare, please note:
- A qualified doctor (such as a podiatrist) must prescribe the shoes or inserts.
- A qualified doctor (such as an orthodontist) must provide and fit you for the shoes or inserts.
- Medicare Part B covers one pair of custom-molded shoes (including inserts) or one pair of depth-inlay shoes per calendar year.
- Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for depth-inlay shoes.
- In certain cases, shoe modifications may be substituted for inserts.
- The supplier must have an order (prescription) on file signed and dated by the treating doctor; if you switch to a different supplier, you may need to have your prescription transferred or get a new prescription from your doctor. Make sure your supplier is enrolled in Medicare.
Other useful information
- Generally, you pay 20% of Medicare-approved amounts for your supplies, and the Medicare Part B deductible applies.
- Make sure you refill your supplies in a timely manner, and only accept supplies you have requested. Medicare won’t pay for supplies you didn’t order; for example, if a supplier automatically sends you items, you cannot get reimbursed by Medicare.
- You may rent or purchase certain diabetic supplies. For more information, call 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048. Customer service representatives are available 24 hours a day, seven days a week.
- Ask if the supplier is a participating supplier in the Medicare program before you get durable medical equipment (DME) for diabetes. If the supplier is a participating supplier, he or she must accept assignment. If the supplier is enrolled in Medicare but isn’t “participating,” he or she has the option to accept assignment or not. If a DME supplier doesn’t accept Medicare assignment, there is no limit to what you can be charged. You also may have to pay the entire bill (your share and Medicare’s share) at the time you get the DME.
- All Medicare-enrolled pharmacies and suppliers must submit claims for diabetic testing supplies. You can’t send in the claim yourself.