What Diabetic Services Does Medicare Cover?

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The first fact you need to know is that you must be enrolled in Medicare Part B forMedicare to cover yourdiabetic services or supplies. If you have a Medicare Advantage plan, you’re required to be enrolled in both Medicare Part A and Part B, so as long as you continue paying your Part B monthly premium, you should be covered as described below.

If you’re not sure whether you’re enrolled inMedicare Part B, look at your red, white, and blue Medicare card, or contact your current health insurance provider.

Medicare Part B covers the following diabetic services, generally requiring your Medicare-participating doctor’s order:

Diabetes screening:Medicare covers tests to check for diabetes if you’re considered at risk for the disease. These screenings may include tests such as a fasting plasma glucose test, or other Medicare-approved tests your doctor may order for you. Medicare may cover these screenings up to twice a year, depending on your risk factors.
Diabetes self-management training:For qualified beneficiaries, Medicare offers a training program that teaches you how to manage your diabetes. It includes education about self-monitoring of blood glucose, diet, exercise, and prescription medications. If you meet certain conditions, Medicare may cover 10 hours of initial diabetes self-management training, to be completed within a year, and two hours of follow-up training each following year.

A portion of the training is individual, with just you and your health instructor, but most of the training occurs in a group setting. There are exceptions that might qualify you for 10 hours of individual training: if you’re blind or deaf, have language limitations, or if no group classes have been available within two months of your doctor’s order for the training.

If you live in a rural area where you might have difficulty finding diabetes management training, it’s possible that you could get this training at a Federally Qualified Health Center (FQHC). For more information, visitMedicare.govor call 1-800-MEDICARE (1-800-633-4227; TTY users call 1-877-486-2048) 24 hours a day, seven days a week.

Yearly eye exam:Medicare covers annual eye exams to screen for diabetic retinopathy once every 12 months. These exams must be done by an eye doctor who is legally allowed to provide this service in your state.
Glaucoma screening:Medicare covers glaucoma screening once every 12 months for people at high risk for glaucoma: those with diabetes or a family history of the disease; African Americans age 50 and older; and Hispanic Americans age 65 and older. The test must be given or supervised by an eye doctor authorized in your state to administer the test.
Medical nutrition therapy (MNT) services:Medicare covers medical nutrition therapy services if you have diabetes or renal disease. To be eligible for this service, your fasting blood glucose has to meet certain criteria and your doctor must prescribe these services for you. These services can be given by a registered dietitian or Medicare-approved nutrition professional. They include a nutritional assessment and counseling to help you manage your diabetes or kidney disease. Medicare covers 3 hours of one-on-one medical nutrition therapy services the first year the service is provided, and 2 hours each year after that. You may qualify for additional MNT hours of service if your doctor determines there is a change in your diagnosis, medical condition, or treatment regimen related to diabetes or renal disease and orders additional MNT hours during that episode of care.
Foot exam:Medicare may cover a foot exam every six months for people with diabetic peripheral neuropathy and loss of protective sensations, as long as you haven’t seen a foot care professional for another reason between visits. Medicare may cover more frequent visits to a foot care specialist if you’ve had a non-traumatic (not because of an injury) amputation of all or part of your foot, or if your feet have changed in appearance, which may indicate serious foot disease.
Hemoglobin A1c Tests:Your doctor might order a hemoglobin A1c lab test. This test measures how well your blood glucose has been controlled over the past 3 months. Medicare may cover this test for anyone with diabetes if it is ordered by his or her doctor.

What diabetic supplies are covered by Medicare Part B?

Medicare Part B covers a variety of diabetic supplies, including blood glucose monitors, test strips, lancets, and lancet devices.

It also covers therapeutic shoes or inserts for individuals with diabetic foot disease. In order to be covered, these supplies must be medically necessary and prescribed by a healthcare provider.

It’s important to note that there may be some limitations and requirements for coverage, so it’s always best to check with your Medicare plan or healthcare provider for specific details.

What do diabetics get free?

People with diabetes who have Medicare may be able to access certain diabetes-related services and supplies at no cost. These services may include an annual diabetes screening, nutritional counseling, and certain vaccines like the flu and pneumococcal vaccines.

What other diabetic supplies are covered by Medicare Part B?

Medicare Part B covers a variety of diabetic supplies, including blood glucose monitors, test strips, lancets, and lancet devices.

It also covers therapeutic shoes or inserts for individuals with diabetic foot disease. In order to be covered, these supplies must be medically necessary and prescribed by a healthcare provider.

It’s important to note that there may be some limitations and requirements for coverage, so it’s always best to check with your Medicare plan or healthcare provider for specific details.

How many test strips does Medicare cover per month 2023?

As of 2023, Medicare Part B typically covers up to 100 blood glucose test strips per month for beneficiaries with diabetes who are not using insulin. However, individuals who use insulin may be able to receive more test strips, depending on their healthcare provider’s prescription and Medicare’s coverage guidelines.

It’s important to note that specific coverage limitations and requirements may apply, so it’s always best to check with your Medicare plan or healthcare provider for more information about your coverage.

Does Medicare pay for eyeglasses for diabetics?

In general, Medicare Part B does not cover the cost of eyeglasses or contact lenses for individuals with diabetes. However, there may be some exceptions for beneficiaries who have undergone certain types of cataract surgery.

In these cases, Medicare may cover one pair of eyeglasses or one set of contact lenses after the surgery, as long as specific conditions are met.

Why does Medicare not pay for insulin?

Medicare Part B does cover certain types of insulin used with an insulin pump, as well as insulin used with durable medical equipment (DME) like an insulin infusion pump. However, Medicare Part B generally does not cover insulin that is self-administered, such as with a syringe or insulin pen.

This is because Medicare considers this type of insulin to be a “drug” rather than durable medical equipment.

Instead, Medicare beneficiaries can obtain insulin coverage through a Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage. These plans may cover various types of insulin, along with other diabetes medications.

About diabetes tests

Medicare covers diabetic screenings, or tests, if you have any of the following risk factors.

High blood pressure
Dyslipidemia (history of abnormal cholesterol and triglyceride levels)
Obesity (with certain conditions)
High blood sugar
Impaired glucose tolerance

Based on the results of these tests, you may be eligible for up to two diabetes screenings every year.

You typically pay 20% of Medicare-approved amounts for outpatient facility charges or doctor services. You pay nothing for preventive diabetes screenings.

What Diabetic Services Does Medicare Cover? | eHealth (2024)