diabetic supplies

Diabetic Supplies

Original Medicare helps cover the cost of blood sugar monitors and a monthly supply of blood sugar test strips if your doctor prescribes a monitor for use in your home. The blood sugar monitor and test strips are covered as durable medical equipment under Medicare

Requirements for Medicare to Cover Blood Sugar Monitors and Test Strips

You must be in treatment for diabetes.
Your doctor must accept Medicare.
Your supplier must be enrolled in Medicare and accept assignment — meaning they are willing to accept the Medicare-approved price for the monitor and test strips.

Medigap and Medicare Advantage May Affect Your Out-of-Pocket Costs

A Medigap policy or a Medicare Advantage plan may cover some of your out-of-pocket costs that Original Medicare does not cover.

A Medigap — or Medicare Supplement insurance — policy can help cover your deductible, coinsurance and any copayment related to a blood sugar monitor and test strips. Medigap plans supplement your coverage if you have Original Medicare.

Medicare Advantage plans replace Original Medicare and are required to cover everything that Medicare Part A and Part B cover. But they may provide extra benefits that Original Medicare does not.

Both Medigap and Medicare Advantage plans are sold by private insurers, and coverage can vary depending on the plan. Talk with your plan’s administrator about what specific coverage your plan may provide when it comes to blood sugar monitors, test strips and other diabetes supplies.

Medicare Covers Blood Sugar Test Strips

Medicare Part B also covers all supplies necessary for the proper use of durable medical equipment. As a result, Medicare Part B covers blood sugar test strips along with lancets and lancet devices. But there may be limits on the number of test strips or other supplies Medicare will cover.

Your cost for supplies follows the same formula as for the monitor — you are responsible for your Part B deductible and 20 percent of the amount charged, while Medicare covers the remaining 80 percent — as long as your doctor and supplier participate in Medicare.

Blood Sugar Monitor vs. Continuous Glucose Control Monitor

For some Medicare beneficiaries with diabetes, a continuous glucose control monitor (CGM) may be a better option than a blood sugar monitor.

But Medicare will pay to replace your blood sugar monitor with a CGM only if you meet certain criteria. These include taking insulin, using an insulin pump, and needing to check your blood sugar levels four or more times a day.

You should talk with your doctor to see if you qualify for a continuous glucose control monitor and if it is a better option for you.

Medicare Part B Limits on Test Strips

a

If you use insulin: Medicare will cover up to 300 test strips and 300 lancets every three months.

b

If you do not use insulin: Medicare will cover up to 100 test strips and 100 lancets every three months.

c

Medicare will cover more than the limited number if your doctor declares additional test strips and lancets are medically necessary. You may need to keep records of your self-treatments to show to Medicare as proof.

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CREDIT: Turner, Terry. “Does Medicare Cover Blood Sugar Monitors and Supplies?” RetireGuide.com, 21 Apr 2022, https://www.retireguide.com/medicare/services/durable-medical-equipment/diabetic-supplies/.