Medicare coverage: diabetic supplies and services

Medicare Part B (medical insurance) and Part D (prescription drug plan) offer coverage for some diabetes supplies and services.

Let’s explore the details of some diabetic supplies and services covered by Original Medicare.

Medicare diabetic coverage at a glance

Generally, Part B covers the services that may affect people with diabetes. Part B also covers certain preventive services for people at risk for diabetes. You must have Part B to get the services and supplies it covers.1

Starting Jan. 1, 2023, Medicare members will pay $35 or less for a 30-day supply of insulin. Learn more about the benefit on the insulin savings benefit page.

To see what Medicare covers and what you pay, review the following chart:

Medicare Diabetic Coverage Chart

Supply/Service What Medicare covers What you pay Anti-diabetic drugs Part D covers anti-diabetic drugs to maintain blood sugar (glucose). Part D deductible, copayments or coinsurance may apply. Diabetes screening tests Part B covers these screenings if your doctor determines you’re at risk for diabetes. You may be eligible for up to 2 diabetes screening tests each year. No coinsurance, copayment or Part B deductible for screenings Generally, 20% of the Medicare-approved amount after the yearly Part B deductible for the doctor’s visit. Medicare Diabetes Prevention Program Part B covers a once-per-lifetime health behavior change program to help you prevent diabetes. Nothing for these services if you’re eligible. Diabetes self-management training Part B covers diabetes self-management training services for people recently diagnosed with diabetes or at risk for complications from diabetes. For Medicare to cover these services, your doctor or other healthcare provider must order it, and an accredited individual or program must provide the services. 20% of the Medicare-approved amount after the yearly Part B deductible. Diabetes equipment and supplies Part B covers home blood sugar (glucose) monitors and supplies you use with the equipment, including blood sugar test strips, lancet devices and lancets. There may be limits on how much or how often you get these supplies. 20% of the Medicare-approved amount after the yearly Part B deductible. Diabetes supplies Part D covers certain medical supplies used to administer insulin (like syringes, needles, alcohol swabs, gauze and inhaled insulin devices). Part D deductible, copayments or coinsurance may apply. Flu and pneumococcal shots Flu shot—To help prevent influenza or flu virus. Part B covers this shot once per flu season in the fall or winter to help prevent influenza or flu virus.
Pneumococcal shot—Part B covers this shot to help prevent pneumococcal infections (like certain types of pneumonia). No coinsurance, copayment or Part B deductible if your doctor or healthcare provider accepts assignment. Foot exams and treatment Part B covers a foot exam every 6 months if you have diabetic peripheral neuropathy and loss of protective sensation, as long as you haven’t seen a foot care professional for another reason between visits. 20% of the Medicare-approved amount after the yearly Part B deductible. Glaucoma tests Part B covers this test once every 12 months if you’re at high risk for glaucoma. A doctor legally authorized by the state must do the test. 20% of the Medicare-approved amount after the yearly Part B deductible. Insulin Part D covers insulin that isn’t administered with an insulin pump. Currently, a Part D deductible may apply. Starting January 2023, you will pay no more than $35 for a 1-month (up to 30 day) supply for all covered Part D insulins. Insulin pumps Part B covers external durable insulin pumps and the insulin the pump uses under durable medical equipment if you meet certain conditions. 20% of the Medicare-approved amount after the yearly Part B deductible. Medical nutrition therapy (MNT) services Part B may cover medical nutrition therapy and certain related services if you have diabetes or kidney disease. Your doctor or other healthcare provider must refer you for these services. No copayment, coinsurance or Part B deductible if your doctor or healthcare provider accepts assignment. Therapeutic shoes or inserts Part B covers therapeutic shoes or inserts if you have diabetes and severe diabetic foot disease. 20% of the Medicare-approved amount after the yearly Part B deductible. “Welcome to Medicare” preventive visit Within the first 12 months you have Part B, Medicare covers a 1-time review of your health, and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed. No copayment, coinsurance or Part B deductible if your doctor or healthcare provider accepts assignment. Yearly “Wellness” visit If you’ve already had Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update a personalized prevention plan based on your current health and risk factors. No copayment, coinsurance or Part B deductible if your doctor or healthcare provider accepts assignment. If you had a “Welcome to Medicare” visit, you’ll have to wait 12 months before you can get your first yearly “Wellness” visit.
Note: All of the information in this chart was sourced from the Centers for Medicare & Medicaid Services. For complete details, please review the official government booklet Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs, PDF opens new window.

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Sources

  1. “Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs,” Medicare.gov, last accessed May 16, 2023, https://www.medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf, PDF.