Does Medicare Part B Cover Diabetic Test Strips?
Unravel Medicare Part B's role in covering diabetic test strips. Understand what's covered, eligibility, supply access, and financial responsibilities.
Medicare Part B provides coverage for medically necessary durable medical equipment (DME) and supplies intended for use in the home. This coverage supports individuals in managing various health conditions, including diabetes.
Understanding Medicare Part B Coverage for Diabetic Supplies
Medicare Part B covers specific diabetes self-testing equipment and supplies as durable medical equipment. This includes blood glucose meters, blood glucose test strips, lancet devices, lancets, and glucose control solutions. These items are medically necessary for monitoring blood glucose levels in individuals with diabetes.
Part B also covers durable insulin pumps worn outside the body and the insulin used with these pumps for eligible individuals. Insulin administered by injection, as well as related supplies like syringes, needles, alcohol swabs, and gauze, are covered under Medicare Part D, Medicare’s prescription drug coverage.
Meeting the Requirements for Coverage
For Medicare Part B to cover diabetic testing supplies, a doctor’s order or prescription from a qualified healthcare provider is required. This order must specify that the supplies are medically necessary for the diagnosis or treatment of diabetes.
The prescription should include the diagnosis of diabetes, the specific type of blood sugar monitor and supplies needed, and whether the individual uses insulin. It also needs to indicate how often blood sugar testing is recommended and the quantity of test strips and lancets required each month. A new prescription is needed every 12 months, and beneficiaries must actively request refills.
Obtaining Your Covered Supplies
After a doctor’s order has been established and medical necessity confirmed, beneficiaries can proceed to acquire their covered diabetic supplies. Obtain these supplies from a Medicare-approved durable medical equipment (DME) supplier or pharmacy that accepts assignment. A supplier that accepts assignment agrees to accept the Medicare-approved amount as full payment, charging the beneficiary only the coinsurance and deductible.
Before receiving supplies, individuals should confirm that the supplier is enrolled in Medicare and accepts assignment. Beneficiaries will need to present their Medicare Part B card. Information on finding Medicare-enrolled suppliers is available through Medicare.gov or by calling 1-800-MEDICARE. Medicare emphasizes that it will not pay for any supplies that were not specifically requested or those sent automatically by suppliers.
Your Share of Costs and Quantity Limits
Beneficiaries are responsible for a portion of the cost of their diabetic testing supplies under Medicare Part B. After meeting the annual Part B deductible, which is $240 in 2024 and $257 for 2025, Medicare pays 80% of the Medicare-approved amount for these supplies. The individual is then responsible for the remaining 20% coinsurance.
Medicare also sets quantity limits for test strips and lancets. For individuals who use insulin, Part B covers up to 300 test strips and 300 lancets every three months. For those who do not use insulin, the coverage is limited to 100 test strips and 100 lancets every three months. If a doctor determines that more supplies are medically necessary, Medicare may allow additional quantities, which might require keeping a record of testing frequency. Supplemental insurance plans, such as Medigap policies, can help cover the 20% coinsurance.