Did you know Medicare beneficiaries are eligible to receive coverage for diabetic supplies they use every day? Medicare can cover a range of prediabetic and diabetic supplies and services, including diabetic shoes and individual health coaching through the Medicare Diabetes Prevention Program. Read on to see what diabetic supplies are covered by specific Medicare Parts and how the Medicare Diabetes Prevention Program works.
When it Comes to Diabetes, What Does Medicare Cover?
There are many programs within Medicare that can help offset the costs of diabetes treatment.
Original Medicare (Parts A and B)
The Centers for Medicare & Medicaid Services reports that Medicare Part B will generally cover equipment and supplies like home blood sugar monitors and tools for measuring blood sugar, including:
- Lancet devices
- Test strips
- Glucose control solutions
Medicare Part B will also cover external insulin pumps and the insulin required for the pump, if you meet certain conditions.
The U.S. Department of Health and Human Services reports that those using Original Medicare can also have diabetes supplies delivered through the National Mail-Order Program. With this program, you’ll select a national mail-order contract supplier for Medicare in your zip code using the official U.S. government website for Medicare. This supplier will help you get quality supplies at a discount.
Additionally, if you have diabetes and severe diabetic foot disease, Medicare Part B includes some specialized shoe coverage. One pair of custom shoes plus their inserts and one pair of extra-depth shoes are covered once a year under Medicare Part B, according to the official U.S. government website for Medicare.
Medicare Part D
Medicare Part D helps cover the cost of prescription drugs through private insurance companies. The Centers for Medicare & Medicaid Services notes that Medicare Part D covers the following:
- Anti-diabetic medications that maintain glucose levels in the blood
- Injected or inhaled insulin that isn't administered with a pump
Part D also covers diabetic supplies like:
- Alcohol swabs
- Insulin inhalers
Medicare Part D beneficiaries have a copayment or coinsurance payment, and a Medicare Part D deductible may also apply. Check your plan for the specific costs associated with the particular medications you use.
Additionally, the Centers for Medicare & Medicaid Services notes that beneficiaries may be able to join special drug plans participating in the Part D Senior Savings Model. These plans, available to everyone enrolled in Medicare, include coverage options that offer several types of insulin at a capped copayment of $35 for a 30-day supply. This can cut your out-of-pocket yearly expenses by up to $446.
Medicare Diabetes Prevention Program
According to the Centers for Disease Control and Prevention, almost half of the population over age 65 has prediabetes. People with prediabetes have higher blood sugar levels than normal, but not high enough to be considered diabetic. A blood test from your doctor will confirm if you are prediabetic.
The Medicare Diabetes Prevention Program can help stall or prevent Type 2 diabetes by teaching you healthy habits. The program helps you to create realistic goals for lifestyle changes with a coach, learn strategies to control weight, and connect to a support group of people with common goals. According to the Centers for Disease Control and Prevention, you may be eligible for this program if you:
- Are enrolled in Medicare Part B through original Medicare or a Medicare Advantage plan.
- Have a Body Mass Index (BMI) of 25 or higher (or a BMI of 23 or higher if you identify as Asian)
- Have no history of Type 1 or Type 2 diabetes
- Do not have end-stage renal disease
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