Healthcare Educators


Medicare Coverage for Diabetes

by | Feb 21, 2018

Diabetes is a chronic condition that can require ongoing treatment and monitoring. It is also a common condition that affects millions of Americans, many of whom do not realize they have the disease. Therefore, to manage diabetes while keeping costs down, it’s important to have coverage for screenings and care. Medicare beneficiaries have access to coverage for diabetes.

What Is Diabetes?

There are different forms of diabetes, including type 1, type 2 and gestational. Type 2 diabetes is the most common form of diabetes, and the risk for developing it increases with age. People who suffer from type 2 diabetes experience abnormally high levels of blood sugar, called glucose.

Diabetes increases the risk of stroke, heart disease, glaucoma, cataracts, infections, nerve damage, foot problems and high blood pressure. It’s important to manage diabetes through a combination of medicine, diet and exercise. People with diabetes may need to monitor their blood sugar levels.

The CDC reports that 30.3 million Americans have diabetes, and one in four adults with the condition don’t know they have it. Even more Americans – 48.3 percent of adults aged 65 or older – have prediabetes, which means they are at risk of developing diabetes in the next five years. Only 11.6 percent of people with prediabetes are aware of it.

How Does Medicare Cover Diabetes?

Medicare Part B covers up to two diabetes screenings per year for people who are at risk. Patients who are diagnosed with diabetes receive coverage for some related supplies and services, including the following:

  • Blood sugar testing monitors and strips
  • Insulin pumps and the insulin used by insulin pumps
  • Lancet devices and lancets
  • Blood sugar control solutions
  • Therapeutic shoes or inserts for people with severe diabetic foot disease
  • Diabetes self-management training for people who have recently been diagnosed with diabetes
  • Yearly eye exam
  • Foot exam
  • Glaucoma tests
  • Nutrition therapy services

Medicare Part D also provides coverage for certain anti-diabetic drugs, insulin that is not administered using an insulin pump and medical supplies needed to administer insulin. For more information, and to see how much Medicare beneficiaries can expect to pay, see Medicare’s Coverage of Diabetes Supplies & Services.

Are Other Coverage Options Available?

Medicare beneficiaries can also consider Medigap policies or Medicare Advantage for coverage.

When selecting a Medicare Advantage plan, the American Diabetes Association recommends that patients with diabetes check the formulary to see how medications and supplies needed to treat diabetes are covered. Some diabetic carriers also cover diabetic shoes and insulins. Contact us for details.