If you need supplies for your diabetes, the right insurance will get you the right prices. Here is how Medicare coverage works for diabetic supplies.
Did you know that over 34 million Americans have diabetes? Type 2 diabetes is more common and affects about 32 million U.S. residents. About 1.25 million people in America have Type 1 diabetes.
Each person needs diabetic supplies to manage their disease. These supplies are expensive, and most people rely on insurance to afford what they need. Keep reading to learn more about Medicare coverage for diabetic supplies.
What Is Diabetes?
There are two types of diabetes. A type 1 diabetic’s body doesn’t make insulin. Insulin moves glucose (sugar) from the bloodstream into the cells. Without insulin, glucose builds up in the bloodstream causing a metabolic imbalance.
Type 2 diabetic’s bodies make insulin, but the body can’t use it properly. This can also cause the glucose to stay in the bloodstream.
Treatment for Diabetes
The treatment is different for each type of diabetes. Type 1 diabetic’s treatment involves:
- Monitoring carbohydrates, fat, and protein intake
- Checking blood sugar regularly and as needed
- Taking insulin
- Healthy eating
- Keeping a healthy weight
- Regular exercise
Some type 2 diabetics control their blood sugar levels with diet and exercise. Others need medications to help their insulin work properly. Providers may order insulin to manage the disease.
Diabetic Supplies
There are many types of supplies needed to manage diabetes. Type 1 diabetics need insulin daily to keep blood sugar levels within a set range. They also need glucagon with them to treat severe hypoglycemia.
Many people with diabetes use insulin pumps. This delivers a continuous baseline amount of insulin. Users put their carbohydrate count in the pump, and it calculates and delivers the insulin needed.
Diabetics must also check their glucose level using test strips and glucose monitors. Continuous glucose monitors check glucose constantly. Alarms sound if the blood sugar gets too high or too low.
Plans for Medicare
“Original Medicare” includes Part A and Part B. Part A covers hospitalization and skilled nursing facility care. Part B covers outpatient services including doctor visits, lab tests, and outpatient procedures.
You also have the option of buying extra coverage. Private insurers offer Medicare Advantage (Part C). This covers prescriptions and vision and dental care.
Medicare Part D covers prescription medications. Many Medicare beneficiaries use these and other supplements to cover their medical costs.
How Medicare Works
Original Medicare enrollees pay a deductible for each enrollment period. Then, Medicare pays for part of your care and you pay a co-pay. Part B usually charges a monthly premium.
You must use Medicare-approved healthcare providers and businesses that sell supplies. There’s no limit on the amount you pay out-of-pocket each year. The gap plans pay their part after Medicare pays.
Medicare Coverage for the Cost of Diabetic Supplies
Medicare Part B covers about 80% of diabetic supply costs. This means you pay 20% plus any deductibles or co-pays that apply. Medicare requires a prescription from your provider before it will cover diabetic supplies.
Part B covers the following supplies when bought from Medicare-approved suppliers:
- Blood glucose testing monitors
- Glucose test strips
- Lancets
- Glucose solution
- Blood sugar control solution
- Insulin pumps
- Therapeutic shoes or inserts
Part B doesn’t cover insulin, but Part D pays for certain types of insulin. Part D also covers syringes, needles, alcohol swabs, gauze, and inhaled insulin devices.
Are You Looking for Answers to Your Medicare Option Questions?
Medicare-eligible diabetics need to know how Medicare pays for diabetic supplies. In addition to Original Medicare, there are many different gap plans available.
Senior Affairs provides information about Medicare plans without any bias. We collect information from public and private sources including cms.gov. Read our blogs to improve your understanding of the Medicare system.