Types of Diabetic Supplies Covered by Medicare

Medicare covers some diabetes supplies, including:

• Blood glucose test strips
• Blood glucose monitor
• Lancet devices and lancets
• Glucose control solution for checking the accuracy of test strips and monitors.

There may be limits on how much or how often you get these supplies; The limits will vary with the type of coverage you have (Part B cover, Medicare Advantage Plan).

Insulin:

Medicare Part B does not cover the cost of insulin unless you use an Insulin pump. If you inject your insulin with a needle (syringe), the Medicare prescription drug benefit (Part D) covers the insulin and the supplies necessary to inject it:, which includes: syringes, needles, alcohol swabs and gauze. Your Part D plan will cover the insulin and any other medications to treat your diabetes at home as long as they are on your plan's formulary.

Here are some things you can do to make sure your diabetes medical supplies are covered by Medicare:

• Only accept supplies you have ordered. Medicare will not pay for supplies for which you didn't have a prescription .
• Medicare won't pay for supplies sent from the supplier to you automatically. You have to request them each time you need them.
• You can't send in the claim yourself. Claims must be submitted by the Medicare-enrolled pharmacies and suppliers from which you ordered

What Will Diabetes Supplies Cost Me?

How much you pay will depend on what type of coverage you have and where you buy your supplies. Diabetic supplies are covered under Medicare Part B. In January 2006, coverage for injectable insulin became available under the Medicare Part D Program. You must be enrolled in Part D to receive this benefit. However, in general, if you are enrolled in Medicare:

• After you have paid your yearly deductible, you will pay 20 percent of the approved Medicare amount for the cost of the diabetes supplies.
• You will pay less if you buy from a supplier who accepts assignment. A supplier who accepts assignment has agreed not to charge more than the Medicare allowed amount and will not charge more than the 20 percent co-pay.
• If you have a Medigap/supplemental policy, you might not pay anything for your supplies.
• If you receive your Medicare through a Medicare Advantage Health Plan, you may owe little to nothing depending on the plan with which you have signed up and your benefits with the plan.

It is important to do your homework. Read about the factors that affect how much coverage you will receive. Make sure all paperwork is completed correctly and that you buy your equipment through an approved supplier that accepts assignment. For more information you may speak directly with a coverage expert who is an approved supplier.

***Note: This is a free call with an expert in diabetic supplies covered by Medicare. There is no obligation to buy anything.

Where Do I Buy the Diabetes Supplies?

You will save money if you order from a Medicare approved provider. Suppliers must meet strict standards to qualify as a Medicare supplier and will have a Medicare supplier number. You may also buy your supplies from any store that sells them. However, if the supplier from which you order your supplies is not enrolled in Medicare, Medicare will not pay for them.

Things you should think about before you choose a supplier:

• There are two types of Medicare suppliers, participating suppliers and those who are enrolled but have chosen not to participate.
• Participating suppliers will not charge more than the Medicare allowed amount.
• A Medicare approved provider who does not want to participate can charge more than the Medicare-approved amount. However, they cannot charge more than 15 percent above the Medicare-approved amount. They may also ask you to pay the entire bill when you pick up the supplies. In this situation Medicare will send the reimbursement directly to you. However, be prepared to wait; it may take a couple months to receive payment.

If you receive your Medicare coverage through a Medicare Advantage Plan (HMO or PPO), it is likely that the plan will have its own steps diabetes supply purchases. In addition, the plan may have restrictions on the supplier from which you can buy. It is important to know that your health plan must supply at least what Medicare covers -- they cannot supply less. Depending on your plan you may actually receive more coverage than you would get with Medicare alone. It is wise to call your Medicare Advantage Plan'ss customer service and ask about your coverage before you order any diabetes supplies.

If you wish to speak with a coverage expert about your diabetic supplies and how they might be covered by Medicare or other private insurance, click on the link below. You will be connected to a representative who can assist you.