When it comes to diabetic supplies covered by Medicare, it’s important to keep in mind that Original Medicare covers most basic diabetes supplies—including annual diabetes wellness checks, testing supplies, and insulin pumps. You may still have to pay a copay, though, and you may not get full coverage for all of the supplies you need or want. A Medicare Advantage plan may offer broader coverage, depending on your diabetes care needs.
When it Comes to Diabetes, What Does Medicare Advantage Cover?
In order to understand Medicare Advantage diabetes coverage, it’s important to first understand what Original Medicare covers for diabetes. The Centers for Medicare & Medicaid Services reports that Original Medicare (Parts A and B) offers coverage many basic diabetes supplies, including:
- Annual diabetes prevention, screening, and wellness checks
- Blood sugar monitoring equipment such as lancets and blood glucose monitors—with limits on which supplies you can use or how often you can buy them
- Durable insulin pumps and the accompanying insulin, under certain conditions
- Diabetes-related foot care for those who have peripheral neuropathy and a loss of protective sensation, including foot exams as well as orthotic diabetes shoes and inserts
Medicare Advantage plans are an alternative to Original Medicare. Advantage plans are supplied by private companies that must follow Medicare’s rules and regulations. While all Advantage plans must offer all of the benefits of Original Medicare, they may come with different rules, costs, rights, protections, and options.
Many Medicare Advantage plans provide benefits you cannot get with Original Medicare. According to the Centers for Medicare and Medicaid Services, some Medicare Advantage plans cover additional diabetes supplies and services, including:
- Prescription drug coverage for insulin injection supplies and diabetes drugs
- Additional or different diabetes testing supplies
- More comprehensive foot or eye care
- Dental care, which can be critical for people with diabetes
- Complementary or alternative care for diabetes
- Prescription drug coverage
With Medicare Advantage, you’ll also have an annual out-of-pocket limit that may help you spend less on health care.
The specific Medicare Advantage plans available to you will vary according to your region. It’s important to shop around, and to review specific plan documents to know what’s covered.
The deductibles and copays will also vary with Medicare Advantage, so it’s important to compare your potential Advantage benefits to those you get with Original Medicare to ensure you get the best possible deal. You can compare plans using the official U.S. government website for Medicare.
People with diabetes may also be eligible for Medicare Advantage Special Needs Plans (SNPs), which provide care for certain conditions, including chronic illnesses like diabetes, under the guidance of in-network expert providers. The availability of these plans varies by region.
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