Medicare's Diabetes Care and Prevention Benefits

Mary Ann HodorowiczBy Mary Ann Hodorowicz RD, LDN, MBA, CDE, CEC

For people with diabetes (PWDs), and people at risk for diabetes (PRDs) who are on Medicare, you will be very happy you read this article!  You can maximize your health and well-being from tapping into all the diabetes care and preventive benefits Medicare offers when they are needed.  The secret to receiving all these benefits is for the beneficiary to first know about them, and second to be proactive about discussing them with your primary care provider on a regular basis.  Here is a concise summary to accomplish your first step….know what your benefits are:

Blood Glucose (BG) Self-Testing Equipment and Supplies

BG self-testing equipment and supplies are covered as durable medical equipment (DME) for PWDs with Medicare Part B even if not on insulin.  This includes:

  • BG testing meters
  • BG test strips
  • Lancet devices and lancets
  • Glucose control solutions for checking the accuracy of testing equipment and test strips

The amount of supplies that are covered varies depending on whether the PWD uses insulin or not.

Insulin Pumps

Insulin pumps worn outside the body (external), including the insulin used with the pump, may be covered for some people with Medicare Part B who have diabetes and who meet certain conditions.  Insulin pumps are considered to be durable medical equipment . "Durable medical equipment" is certain medical equipment ordered by your doctor for use in the home.

Therapeutic Shoes or Inserts

If you have Part B, have diabetes, and meet certain conditions (see below), Medicare will cover therapeutic shoes if you need them.

Insulin

Medicare drug plans cover injectable insulin not used with an insulin infusion pump and inhaled insulin.

Anti-Diabetes Prescription Drugs

Blood sugar (glucose) that isn't controlled by insulin is maintained by anti-diabetic drugs.  Medicare drug plans can cover anti-diabetic drugs like:

  • Sulfonylureas
  • Biguanides (like metformin)
  • Thiazolidinediones
  • Meglitinides
  • Alpha glucosidase inhibitors

Diabetes Supplies

These supplies used when you inject or inhale insulin may be covered for people with Medicare Part D who have diabetes:

  • Syringes
  • Needles
  • Alcohol swabs
  • Gauze
  • Inhaled insulin devices

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Last Modified Date: January 14, 2014

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