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How Medicare Covers Diabetic Supplies And Where to Get Help

Managing diabetes effectively is extremely important and requires reliable access to the necessary supplies. For Medicare beneficiaries living with diabetes, understanding what’s covered and how insurance pays for it is essential. As a Medicare agent, helping clients navigate these benefits can make a real difference in their quality of life. We will go over Medicare payment of diabetic supplies and provide information on how to get help locating and paying for them.

Diabetic Supplies Medicare Covers

Medicare Part B (Medical Insurance) covers certain diabetic supplies for all beneficiaries who have diabetes, whether they use insulin or not. Here’s what they typically cover:

• Blood glucose monitors
• Blood sugar test strips
• Lancets and lancet devices
• Glucose control solutions
• Continuous Glucose Monitors (CGMs) and related supplies

For beneficiaries who use insulin, Medicare also covers insulin pumps and pump-related supplies under Part B if the pump qualifies as durable medical equipment (DME).

Important: Insulin itself (unless used with a pump) syringes, needles, alcohol swabs, and gauze are generally covered under Medicare Part D (the prescription drug benefit).

How Much Medicare Pays

Under Medicare Part B, Medicare pays 80% of the Medicare-approved amount for covered diabetic supplies after the beneficiary meets the Part B deductible. The beneficiary is responsible for the remaining 20% unless they have additional coverage (like a Medigap plan or Medicaid) that helps with cost-sharing.

If diabetic supplies are obtained through a Medicare-enrolled supplier, the beneficiary avoids unnecessary out-of-pocket costs. That’s why it’s essential to work with reputable providers who are participating providers under Medicare.

Where to Get Supplies: Advanced Diabetic Supply Group

One of the most trusted names in diabetic supply delivery is the Advanced Diabetic Supply Group (ADS).

Here’s why Medicare beneficiaries and agents should consider ADS:

Watch a YouTube video on Advanced Diabetes Supply and how they can help your clients

• Medicare-Enrolled Supplier: ADS is an accredited Medicare DME provider, which means they meet strict compliance and billing standards.
• Home Delivery: Supplies are shipped directly to the beneficiary’s home—saving time and eliminating pharmacy trips.
• Bilingual Support: ADS offers customer service in English and Spanish, making communication easier for diverse clients.
• Insurance Coordination: They work directly with Medicare and many private insurance plans to verify coverage and handle paperwork.

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As an agent, you can refer clients to ADS knowing they’ll receive quality care and proper billing, which leads to better health outcomes and fewer surprises.

Tips for Agents and Beneficiaries

• Stay enrolled: Ensure your client’s Medicare coverage is active and updated.
• Verify suppliers: Always use Medicare-approved suppliers to avoid denied claims or excessive costs.
• Review needs annually: Reassess whether your client’s current plan covers all their diabetic needs, especially during the Annual Enrollment Period (AEP).

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Because diabetes affects millions of Americans, understanding Medicare diabetes coverage is extremely important to both agents and those affected by diabetes. For diabetics, proper management and access to supplies is essential to maintaining health and quality of life. Fortunately, Medicare provides comprehensive coverage for diabetes-related services and supplies. It’s important to understand what Medicare covers and how to maximize benefits.

Medicare Part B

Medicare Part B covers a variety of diabetes-related supplies and services, including:

Blood Sugar Testing Supplies – This includes blood glucose monitors, test strips, lancets, and control solutions. Medicare generally covers up to 300 test strips and lancets every three months for insulin-dependent beneficiaries and up to 100 for non-insulin users.

Continuous Glucose Monitors (CGMs) – Medicare covers therapeutic CGMs and related supplies for qualifying individuals who meet specific criteria.

Insulin Pumps and Insulin for Pumps – Medicare covers insulin pumps as durable medical equipment (DME) and the insulin used in these pumps.

Medical Nutrition Therapy (MNT) – Beneficiaries with diabetes may receive MNT services, including nutritional assessment and counseling.

Diabetes Screenings – Medicare covers two diabetes screenings per year for beneficiaries at risk of developing diabetes.

Diabetes Self-Management Training (DSMT) – A critical education service that helps patients learn how to manage their diabetes effectively.

Medicare Part D: Prescription Drug Coverage

While Medicare Part B covers insulin used in pumps, Medicare Part D (Prescription Drug Plans) covers most other types of insulin, as well as oral diabetes medications, needles, syringes, and certain related supplies. Coverage may vary based on the specific Part D plan, so it’s important to review formulary lists and copayment amounts before enrolling in a plan.

Medicare Advantage (Part C) and Supplemental Coverage

Medicare Advantage (MA) plans must cover everything Original Medicare (Part A and Part B) covers but often include additional benefits, such as expanded prescription drug coverage, wellness programs, and cost-sharing assistance for diabetes management. Some plans may also offer broad access to CGMs and other advanced diabetes care.

How to get Medicare covered diabetes supplies

It is important to always use suppliers and pharmacies that are part of your Medicare plan’s network. Check with the plan provider for specific requirements and preferred providers. Beneficiaries must obtain a prescription from their doctor for blood sugar testing supplies.

Click here to download Medicare coverage of diabetes supplies, services & prevention programs

Medicare provides extensive support for individuals with diabetes, but navigating coverage details can be complex. Understanding what’s included under Medicare Part B, Part D, and Medicare Advantage plans helps beneficiaries make informed decisions and access necessary supplies for effective diabetes management.