Dear Marci,
I have Original Medicare and a stand-alone Part D plan. How will my diabetes supplies and insulin be covered?
– Blake (Laramie, WO)
Dear Blake,
This is an important question, as Medicare covers diabetes supplies in different ways depending on what you need. Original Medicare Part B (medical insurance) covers some diabetes supplies, and Medicare Part D (prescription drug benefit) covers others.
Specifically, Part B covers certain diabetes supplies as durable medical equipment (DME). This means that you must get a prescription from your doctor and use an appropriate provider. For Original Medicare, this can be a supplier that is part of a competitive bidding program or a Medicare-certified supplier, depending on where you live.
Part B covers the following
- Glucose
- Blood sugar (glucose) test
- Lancet devices and
- Insulin used with an insulin
- Glucose control
- Therapeutic shoes or inserts
- Insulin that is used with an insulin pump
You pay 20 percent of the cost of the Medicare-approved amount and Medicare pays 80 percent of the cost. If you have questions about durable medical equipment and diabetes supplies, you can call 1-800-MEDICARE for more information, and to find a supplier in your area.
Alternatively, if you inject your insulin with a needle, then Part D covers the cost of insulin and the supplies necessary to inject the insulin. This includes syringes, needles, alcohol swabs, and gauze. Your stand-alone Part D plan will also cover other medications to treat your diabetes at home, as long as they are on your plan’s list of covered drugs.
Depending on the type of supplies you are using, either Medicare Part B or Part D will cover the cost of the supplies you need. You can speak with your doctor to learn more about your health care needs.
– Marci