Medicare Diabetic Supplies - What's Covered

Medicare Diabetic Supplies

If your parent or spouse has been diagnosed with diabetes, understanding what's covered and what's not under Medicare will help budget costs.

Medicare Part B and Medicare Part D cover doctor services, outpatient care, and prescription drugs, respectively. Understanding what covers what and how much you may be expected to pay for services or supplies will help you make educated and knowledgeable decisions and choices regarding medical care.

Medicare Diabetic Supplies and Services

Medicare Part B covers diabetes screenings or tests that determine whether or not an individual has diabetes. However, the screenings are generally only suggested if a senior is experiencing hypertension or high blood pressure, a family history or personal history of high cholesterol or triglyceride levels, history of high blood sugar or obesity.

Diabetic screening may also be performed if you're over 65 years of age and have a family history of diabetes or a history of gestational diabetes, or diabetes that presents during pregnancy. In most cases, two diabetic screenings every year are covered under Medicare.

Medicare Diabetic Supplies

Diabetic screenings don't require coinsurance or co-payment or Part B deductibles, though you may be required to pay 20% of the approved amount for the doctor visit.

When it comes to medicare diabetic supplies, Medicare Part B or Part D may come into play. For example, diabetic supplies such as self testing equipment, glucose, test strips, testing monitors, lancets or lancet devices are covered under Medicare Part B. Be sure to check how often the supplies are needed or how many you can purchase at one time. In most cases, you only need to pay 20% of the Medicare approved amount after you've met your Part B yearly deductible.

Medicare Diabetic Supplies

Medicare diabetic supplies covered by Part D may include the medicare diabetic supplies or equipment needed to monitor your condition such as needles, syringes, gauze, alcohol swabs, and so forth. In such cases, you'll pay coinsurance or co-payment, and you may need to meet Part B deductibles as well.

Insulin is covered under Medicare Part D unless the insulin is administered with an insulin pump (in which case it may be covered my Part B). You'll pay coinsurance and co-payments, although Part B deductibles may apply. Insulin pumps are covered under Medicare Part B under Durable Medical Equipment, though certain conditions must be met.

Therapeutic shoes or inserts for those who have been diagnosed with diabetic foot disease are covered under Medicare Part B, though such shoes or inserts are required to be prescribed by a podiatrist or another qualified doctor. You'll be required to pay 20% of the Medicare approved amount after yearly Part B deductibles have been met.

Anti diabetic drugs such as glucose don't require a coinsurance or co-payment, though you may need to meet your deductible for Medicare Part D, or prescription drug coverage plan.

Other Diabetic Services

Medicare Part B also covers foot exams and treatments, as diabetics are especially susceptible to non-healing injuries or wounds, diabetic peripheral neuropathy or loss of sensation in the feet. In such situations, Medicare recipients will be required to pay 20% of the Medicare approved amount after yearly Part B deductibles have been met.

Medicare Part B will also cover tests to determine whether or not you're suffering from eye disease or glaucoma. Glaucoma is relatively common among diabetic patients, and you'll be able to undergo testing once a year if you've been considered a high risk for glaucoma. Individuals who are considered high risk may include:

  • African Americans (over 50 years of age)
  • Hispanics (and over 65 years of age)
  • Family history of glaucoma
  • If you've been diagnosed with diabetes

It's important for consumers to understand what's covered and what's not covered by Medicare. Individuals unable to meet co-payments, coinsurance or deductibles may qualify for a low income subsidy from Medicare for prescription drugs or medications if yearly income is below $15,600 for singles or $21,000 if you're married and living with a spouse with no dependents.

Resources must be less than $12,000 for singles or $24,000 for married individuals.

Conclusion

Talk to your doctor about basic Medicare coverage for diabetes treatment. For in-depth information, log on to Medicare.gov and browse through their publications and resources regarding diabetes, diabetic care, treatments and supplies. 

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