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 | 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. | The cost of a 1-month supply (up to 30 days) of each Part D-covered insulin covered by your plan is capped at $35. You don’t have to pay a deductible. |
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. The $35 monthly cap does not apply to the cost of insulin pumps. |
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 | No copayment, coinsurance or Part B deductible if your doctor or healthcare provider accepts assignment. |
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