Medicare Part B Coverage
If as a beneficiary you have Part B coverage in your Medicare plan, then glucose meters and many other diabetic management supplies are covered.
Also, as a Medicare cardholder and not sure about if you have diabetes, you are eligible for up to two Fasting Blood Glucose tests. There are no costs to you if your doctor accepts assignment.
Supplies covered by Medicare include:
• Blood Glucose testing supplies
Equipment and Supplies Covered by Medicare Part B
• Lancing devices
• Control Solution
The Medicare Part B coverage varies depending on if they use insulin or not.
If the beneficiary uses insulin, they can get 1 new lancing device every 6 months and up to 100 lancets along with a max of 100 tests strips every month.
If as the beneficiarty you do not use insulin, your lancing device stays at 1 every 6 months, but you are limited to 100 test strips and lancets every 6 months. That is covered and obviously not enough testing to get good blood glucose management. We offer plans to pro-rate the difference and you are still left with a large discount.
Insulin Pumps and the Insulin Used in the Pumps
Insulin pumps worn externallly, including the insulin used with the pump, may be covered if certain conditions are met. For a patient to get insulin pump coverage, their doctor will need to prescribe the need for the device. In the Original Medicare Plan, the beneficiary pays 20% of the Medicare-approved amount after the yearly Part B deductible. Medicare will pay 80% of the cost of the insulin pump. Medicare will also pay for the insulin that is used with the insulin pump.
Medicare Part B covers the cost of insulin pumps and the insulin used in the pumps. However, if the beneficiary injects their insulin with a needle (syringe), Medicare Part B DOES NOT COVER the cost of the insulin, but the Medicare prescription drug benefit (Part D) covers the insulin and the supplies necessary to inject it. This includes syringes, needles, alcohol swabs and gauze. The Medicare Part D plan will cover the insulin and any other medications to treat diabetes at home as long as the beneficiary is on the Medicare Part D plan"s formulary.
Coverage for diabetes-related durable medical equipment (DME) is provided as a Medicare Part B benefit. The Medicare Part B deductible and coinsurance or copayment applies after the yearly Medicare part B deductible has been met. In the Original Medicare Plan, Medicare covers 80% of the Medicare-approved amount (after the beneficiary meets their annual Medicare Part B deductible of $135 in 2009), and the beneficiary pays 20% of the total payment amount (after the annual Part B deductible of $135 in 2009). This amount can be higher if the beneficiary"s doctor does not accept assignment, and the beneficiary may have to pay the entire amount at the time of service. Medicare will then send the beneficiary its share of the charge.
Medicare Part D Covered Diabetic Supplies and Medications
This section provides information about Medicare prescription drug coverage (Part D) for beneficiaries with Medicare who have or are at risk for diabetes. If a beneficiary wants Medicare prescription drug coverage, they must join a Medicare drug plan.
The following diabetic medications and supplies are covered under Medicare drug plans:
• Diabetes Supplies
• Insulin and
• Anti-diabetic drugs
Diabetes supplies associated with the administration of insulin may be covered for all people with Medicare Part D who have diabetes.
These medical supplies include the following:
• Alcohol Swabs
• Gauze and
• Inhaled Insulin Devices
Injectable insulin not associated with the use of an insulin infusion pump is covered under Medicare Part D drug plans.
For more information on Medicare coverage for diabetic testing supplies contact us via our contact form.