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What Does Medicare Cover for Diabetics?

Diabetes is a serious and common disease, especially among our senior population. It is the seventh leading cause of death nationwide and in Hawaii. People with diabetes are at greater risk of developing health complications such as eye disease, cardiovascular disease, and kidney disease. Because of these risk factors, diabetes disease management is incredibly important. Diabetes management requires wellness checks and a list of diabetes supplies all of which can be expensive if they are not covered in your health plan. If you have diabetes and are getting ready to transition from employer or individual health insurance to Medicare, you may be wondering what Medicare covers for diabetics.

What Does Medicare Cover for Diabetics?

Original Medicare covers annual diabetes prevention, screening, and wellness checks under Medicare Part B (medical insurance). Foot exams are covered for those who have peripheral neuropathy and a loss of protective sensation.

Medicare Part B also covers a range of durable medical equipment including diabetic supplies. Original Medicare covers the same supplies for both insulin and non-insulin dependent diabetics.

Covered supplies include:

  • Glucose testing monitor

  • Insulin pumps

  • Blood glucose test strips

  • Lancets

  • Spring powered devices for lancets

  • Glucose control solutions

  • Orthotic diabetes shoes and inserts (for those who have peripheral neuropathy and a loss of protective sensation)

Note: Some frequency and type limitations and co-pays may apply.

Does Medicare cover insulin for diabetics?

Original Medicare does not cover insulin for diabetics unless the use of an insulin pump is medically necessary. Since January 1, 2021, many seniors have had access to Medicare drug coverage with a wide range of insulin types that carry a maximum cost of $35 for a 30-day supply. This coverage first became available to seniors during the 2020 Annual Enrollment Period (AEP) by joining a Medicare drug plan or Medicare Advantage Plan with drug coverage that participates in the insulin savings model. This model lets seniors choose among drug plans that offer insulin at a stable and affordable cost.

Does Medicare cover syringes for diabetics?

No, Original Medicare does not cover syringes for diabetics. It also doesn’t cover insulin pens, needles, alcohol swabs, or gauze.

Does Medicare Advantage cover diabetic supplies?

Most Medicare Advantage plans offer additional benefits that Original Medicare does not cover. According to the Centers for Medicare and Medicaid Services, there are some Medicare Advantage plans that cover additional diabetes supplies and services. Medicare Advantage plans may cover:

  • Dental care (very important for people with diabetes)

  • Prescription drug coverage (which can provide access to affordable insulin)

  • Prescription drug coverage for insulin injection supplies and diabetes drugs

  • Access to more or your preferred diabetes testing supplies

  • More comprehensive foot or eye care

  • Complementary or alternative care for diabetes

The specific Medicare Advantage plans available vary based on your location. Within the available plans, each will come with its own coverage, premiums, and deductibles. Ask your Medicare agent about a plan that can help cover your diabetes supplies within a budget you can afford.

Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.

At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.

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