What you Need to Know About Medicare Drug Coverage for Insulin in 2021

Diabetes is a serious and common disease and it is the seventh leading cause of death nationwide and in Hawaii. Diabetes is characterized by high levels of blood glucose or blood sugar. People with diabetes are at greater risk of developing health complications such as eye disease, cardiovascular disease, and kidney disease. Proper management is vital to preventing complications and for many, that includes insulin to help regulate blood sugar.

If you have diabetes and are getting ready to transition from employer or individual health insurance to Medicare, you may be wondering about Medicare drug coverage for insulin and diabetes supplies.

Medicare Drug Coverage for Insulin

Medicare Part B is the Medical Insurance portion of Original Medicare but it doesn’t cover insulin or diabetes supplies, including needles, syringes, insulin pens, alcohol swabs, or gauze.

What does Medicare cover for insulin pumps?

Part B does cover insulin pumps and some medical supplies associated with insulin pumps. Medicare has two categories for insulin pumps: tubed and tubeless. The type of insulin pump you use will determine how much Medicare pays. Medicare Part B covers tubed insulin pumps as durable medical equipment (DME). Other supplies that may be included in this coverage with some limitations are lancet devices and lancets, blood glucose test strips, glucose testing monitors and glucose control solutions.

To get diabetes supplies covered under Medicare Part B, you will need a prescription from your doctor that specifically states that you have been diagnosed with diabetes and what kind of blood glucose monitor and test strips you need and why.