Does Medicare Cover Diabetes Supplies?

If you’re living with diabetes, monitoring and managing your health is a daily task. Having access to the proper supplies can ease the stress that comes with that management. At US MED®, one of the common questions we get is, “Does Medicare cover diabetic supplies?” The simple answer is yes, but how those supplies are categorized and covered is a bit more complex. 

Whether you’ve been managing Type 1 diabetes for decades, or are adjusting to life with Type 2, understanding your Medicare coverage is important. We’re here to help. Keep reading to see a breakdown of Medicare coverage for diabetic supplies, including CGMs, insulin pumps, testing supplies, and more.

Does Medicare Cover Continuous Glucose Monitors?

The Centers for Medicare and Medicaid Services (CMS) has expanded coverage for continuous glucose monitoring (CGM) devices for people living with diabetes. This expanded coverage increases accessibility to this important technology. CGMs can help people living with diabetes manage the condition and are now included under Medicare coverage for diabetic supplies.

Previous Medicare Coverage Requirements for CGMs

Prior to the expansion, Medicare Part B beneficiaries who used a CGM device had to meet with their doctor in person to get a prescription and again whenever they needed refills. They were also required to perform four manual blood sugar finger stick tests per day to maintain coverage for CGM therapy.

New Medicare Coverage Requirements for CGMs

The new coverage requirements are more flexible and easier to meet. Under the new policy, Medicare CGM coverage extends to T1D and T2D patients who treat their diabetes with insulin. There are no longer any finger stick requirements. Non-insulin-using individuals with diabetes can also use Medicare for CGM coverage if they have a documented case of “problematic hypoglycemia.”

If you have diabetes and are considering using a CGM device, the new coverage requirements make it easier than ever to get started. Talk to your doctor about whether a CGM is right for you, and they can help you get a prescription.

It’s important to note that private insurers take their coverage cues from CMS. So if you haven’t qualified for a continuous glucose monitor in the past, now’s the time to give us a call to see if you’re covered under the expanded requirements.

How to Get Continuous Glucose Monitors Covered by Medicare

If you are diagnosed with Type 1 or Type 2 diabetes, follow these steps for Medicare coverage of continuous glucose monitors:

• Take insulin for diabetes or meet the hypoglycemia requirements.
• Have a doctor write a prescription for a CGM.
• Have a doctor approve your caregiver for sufficient training with the glucose monitor.
• Choose a CGM that comes with a receiver or reader. You can also choose a CGM that is integrated with an insulin pump.
• Contact your Medicare Part B carrier to see if you qualify for coverage.
• If you qualify, you will pay 20% of the cost of the CGM.

Here are some additional things to keep in mind:

• Medicare only covers CGMs prescribed by your doctor for use in your home.
• Medicare Part B will typically pay for 80% of the CGM.

You may have to meet certain other requirements, such as regular in-person visits with your doctor.

What Diabetic Supplies are Covered by Medicare Part B?

Medicare Part B covers many diabetic supplies that are considered durable medical equipment (DME). These include testing supplies such as lancets, lancing devices, test strips, and monitors. It also covers non-disposable, or tubed insulin pumps like the Tandem t:slim X2. If you meet specific requirements, you may also get coverage for continuous glucose monitors (CGMs) under Medicare Part B.

Which CGM monitor is presently covered by Medicare Part B?

To be covered under Medicare Part B, CGMs must include a standalone receiver or reader. This means CGMs that only connect with your smartphone are not covered under Medicare Part B. Additionally, you must get a prescription from your provider to obtain a CGM. The following CGMs are currently available for Medicare Part B coverage at US MED®:

• FreeStyle Libre 2 system
• Freestyle Libre 3 
• Dexcom G6
• Dexcom G7

What Testing Supplies are Covered by Medicare Part B?

Traditional blood sugar monitors and meters, test strips, lancets, and control solutions are all covered under Medicare Part B. If you’re a Medicare patient with diabetes who uses insulin, you can get up to 300 lancets and 300 test strips every three months.

Medicare patients with diabetes who don’t use insulin can still get these products, but not in the same amount. Instead, they’re eligible for 100 lancets and test strips in a three-month period. However, you may increase your coverage without using insulin if your doctor says it’s a medical requirement and you provide extra documentation. 

The following glucose meters are covered by Medicare and are available at US MED®:

• True Metrix Air
• Prodigy AutoCode
• Embrace

What Diabetic Supplies are Covered by Medicare Part D?

Part D Medicare coverage for diabetic supplies include injected insulin, inhaled insulin, and supplies for injecting insulin like syringes, alcohol swabs, and needles. Some glucose management medications are also covered under Medicare Part D.

What Insulin Pumps Are Covered by Medicare Part D?

Many tubeless insulin pumps are covered by Medicare Part D. The following tubeless insulin pumps are covered by Medicare and available at US MED®:

• Omnipod DASH
• Omnipod 5

Does Medicare Part D Cover Insulin Pens?

Yes, insulin pens are covered under Medicare Part D for patients with diabetes. US MED® carries needles and syringes in various sizes for insulin pens.

Get Diabetes Supplies Covered by Medicare at US MED®

US MED® is one of the nation’s leading providers of diabetes supplies. Our commitment to quality goes beyond our wide selection of products and unmatched customer service. In addition to accepting 900+ private insurance carriers, we accept Medicare and can even bill Medicare directly for eligible items. Additionally, US MED® is one of the only providers that sends a 90-day supply to Medicare beneficiaries. That means you only need to reorder four times a year instead of twelve. If you have questions about Medicare coverage for diabetic supplies or which supplies are right for you, give us a call today. We’re happy to help!