Medicare Covers Diabetes

What Does Medicare Cover for Diabetes?

Medicare Part B covers screenings, tests, supplies, and prescription drugs to treat and control Diabetes.

Typically, Medicare pays for 100% of the following related to high blood pressure, high blood sugar, and more:

  • Annual eye exam for diabetic retinopathy
  • Annual glaucoma screening
  • Diabetic screening
  • Hemoglobin A1c testing
  • Certain diabetic blood screenings
  • Diabetes self-management training (DSMT)
  • Foot exam (6-month intervals) for diabetic peripheral neuropathy
  • Medical nutrition therapy

Also, Medicare Part B usually covers 80% of the following, depending on whether or not you use insulin:

  • Blood glucose monitors (with a doctor's prescription)
  • Testing supplies like lancets, lancet devices, diabetic test strips, etc.
  • Therapeutic shoes and inserts (based upon certain conditions)
  • Medically necessary external insulin pump & pump supplies (including insulin)

Depending on your plan, Medicare Part D (prescription drug insurance) typically covers 80% of the cost of:

  • Many types of oral diabetes medications
  • Insulin
  • Anti-diabetic drugs
  • Diabetes supplies such as syringes, needles, alcohol swabs, gauze, inhaled insulin devices

Check with your plan to find out if or how your medications are covered.

How to Get Medicare Diabetes Coverage?

There are two ways you can receive Medicare Diabetes coverage. Enroll in either:

  • Original Medicare Part B – This is the health insurance portion of Medicare. It covers doctor's visits, medical services, and more. While most people do not pay a monthly premium for Medicare Part A (hospitalization), they typically pay $144.60 per month for Medicare Part B. If you enrolled in Medicare Part D (prescription drug coverage) and a Medicare supplement, they usually cover more of the expenses that Medicare Part B does not (like copays or coinsurance).
  • Medicare Advantage (Part C) – Medicare Advantage, also known as Medicare Part C, is Medicare-approved coverage administered by private insurers. Medicare Advantage plans "bundle" Medicare Part A and Part B, and often Part D, into a single plan. Often Medicare Advantage provides additional coverage and a $0 per month premium. You must be enrolled in Medicare Part A and Part B and pay the monthly premium to get a Medicare Advantage plan.

Note: If you live in Massachusetts, Minnesota, or Wisconsin, your Medicare supplement policy may be a bit different. Check with your insurer to find out how they cover Diabetes-related care.

How Much Will I Pay for Medicare Diabetes Coverage?

Even with Medicare Part B and Part D, you will pay an annual deductible and 20% of most of your diabetic services, drugs, and supplies.

Therefore, most diabetic patients choose to add a Medicare supplement to reduce out-of-pocket costs. Although you would pay an additional premium for a supplement plan, it will save you more in the long run because of monthly supplies, testing, and treatment.

Alternatively, you can join a Medicare Advantage plan that would also reduce your out of pocket expenses. Medicare Advantage is a popular Medicare-approved substitute that provides comprehensive health insurance through a private insurer. To qualify for Medicare Advantage, you must be enrolled in Medicare Part A and Part B. You can sign up for it during your Initial Enrollment Period, the Annual Enrollment Period, or the Medicare Advantage Open Enrollment Period. Some Medicare Advantage plans have $0 monthly premium.

AARDY Can Help

AARDY is the nation's fastest Medicare insurance marketplace. We can help you find the best Medicare plan to cover Diabetes.

You can compare Medicare supplements and Medicare Advantage plans to find the one that best fits your needs.

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