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Medicare covers many diabetic services, if they are delivered by a doctor or other provider who accepts Medicare assignment. Medicare also covers a range of common diabetic supplies when they’re considered medically necessary.
Different parts of the Medicare program cover the various aspects of diabetic treatment.
Medicare Part B covers diabetic test supplies, screenings, and education for beneficiaries with diabetes, or for those who are at risk for diabetes.
Medicare Advantage, also called Medicare Part C, is optional private insurance. Medicare Advantage plans cover the same diabetic supplies and screenings that Medicare Part B covers. Medicare Advantage plans are required to provide at least the same amount of coverage as Original Medicare (Part A and Part B), except for hospice care.
Medicare Part B covers diabetic supplies such as:
If you get therapeutic shoes or inserts, a podiatrist or other qualified doctor must prescribe them, and a doctor or other qualified individual like a pedorthist, orthotist, or prosthetist must fit and provide the shoes or inserts.
Medicare Part B covers diabetic services such as:
Beneficiaries are responsible for a 20% coinsurance amount after the Part B deductible has been reached for diabetic equipment and supplies. Generally, you pay nothing out-of-pocket for the diabetic screening itself if Medicare covers it, but you may be responsible for a 20% coinsurance for the doctor’s visit.
Medicare prescription drug plans cover certain diabetes-related prescription drugs. This coverage is available through private Medicare-approved insurance providers. You can get this coverage either as a stand-alone Medicare Part D prescription drug plan that works alongside your Original Medicare (Part A and Part B) insurance or by enrolling in a Medicare Advantage Prescription Drug plan which includes your Medicare coverage along with prescription drug coverage all in one plan.
Medicare prescription drug plans may cover the costs of items such as:
Medicare prescription drug plans can vary by provider. Before enrolling in a plan, check to make sure that your diabetic needs will be met. Every plan has a formulary, which is a list of covered drugs. You can review the formulary before deciding to enroll. Joining a Medicare prescription drug plan means you are responsible for a copayment, and, depending on the plan details, a deductible may apply when you buy anti-diabetic drugs or diabetic supplies.
You can go to any pharmacy or other medical equipment supplier that accepts Medicare assignment. If the supplier doesn’t accept Medicare assignment, the supplies might cost you more.
You can choose to get your diabetic supplies by mail order; if you do, see the important information below.
Note about mail-order supplies: If you’re enrolled in Original Medicare (Part A and Part B) and you mail-order these supplies, make sure you get your supplies from a Medicare contract supplier. In many parts of the U.S., Medicare has a competitive bidding program that requires you to choose from a list of approved suppliers. If you live in a competitive bidding area, and you don’t use a Medicare contract supplier, Medicare won’t cover the supplies.
To order diabetic supplies by mail, go to the medicare.gov Find a Supplier page. Start by entering your zip code and clicking Go, and then follow the steps as indicated. Again, this restriction only applies to Original Medicare; if you’re enrolled in a Medicare Advantage plan, contact your plan for a list of approved suppliers.
Be careful not to accept any supplies you didn’t order; generally Medicare won’t pay for them. If a company is sending supplies to you automatically, you’re getting misleading advertisements, or you suspect fraud relating to your diabetes supplies, call 1-800-MEDICARE (1-800-633-4227) to report it. Representatives are available by phone 24 hours a day, seven days a week. TTY users should call 1-877-486-2048.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.