Does Medicare Pay for Blood Glucose Test Strips?

Blood glucose test strips are a routine necessity for individuals managing diabetes, allowing for regular monitoring of blood sugar levels. Understanding Medicare coverage for these supplies is important for beneficiaries to manage health and anticipate costs. This article clarifies Medicare’s coverage for blood glucose test strips and associated equipment, outlining procedures for obtaining supplies and explaining potential out-of-pocket expenses.

Medicare Coverage for Blood Glucose Test Strips

Medicare provides coverage for blood glucose test strips and related self-testing equipment for individuals diagnosed with diabetes. This coverage primarily falls under Medicare Part B. Part B classifies blood glucose monitors, test strips, lancets, lancet devices, and glucose control solutions as durable medical equipment (DME). Coverage requires a doctor’s prescription, confirming a diabetes diagnosis and medical necessity for at-home use.

The quantity of test strips covered by Medicare Part B depends on whether a beneficiary uses insulin. For individuals who use insulin, Medicare generally covers up to 300 test strips and 300 lancets every three months. If a beneficiary does not use insulin, coverage typically extends to 100 test strips and 100 lancets every three months. If a doctor determines that more frequent testing is medically necessary, Medicare may cover additional quantities, often requiring detailed records of testing frequency.

While blood glucose test strips are mainly covered under Part B, Medicare Part D may cover certain diabetes-related supplies. Part D primarily covers insulin, syringes, and some anti-diabetic drugs. Test strips are generally categorized as DME and fall under Part B. Beneficiaries should review their specific Part D plan formulary to understand any potential coverage for test strips, though Part B remains the primary coverage mechanism.

Coverage under Part B requires obtaining supplies from a Medicare-approved supplier who accepts assignment. This ensures the supplier agrees to Medicare’s approved amount as full payment. If a supplier is not Medicare-approved or does not accept assignment, the beneficiary may be responsible for the full cost.

Obtaining Covered Blood Glucose Test Strips

Acquiring covered blood glucose test strips through Medicare begins with a healthcare professional’s order. A valid prescription from a doctor is necessary, specifying the type of test strips, blood glucose monitor, and required testing frequency. This prescription confirms the diabetes diagnosis and medical need for supplies.

Once a prescription is obtained, beneficiaries must select a Medicare-approved Durable Medical Equipment (DME) supplier. Using a Medicare-enrolled supplier is important; Medicare will not pay for claims from suppliers who are not enrolled. Many pharmacies also function as approved DME suppliers, offering a convenient option. Beneficiaries can locate approved suppliers through the Medicare website’s supplier directory or by calling Medicare directly.

The ordering process involves providing the supplier with the doctor’s prescription and Medicare information. Beneficiaries must actively request supplies; Medicare will not pay for items sent automatically or unsolicited. A new prescription for test strips and lancets is typically required every 12 months to continue coverage. Supplies are often delivered directly to the beneficiary’s home or picked up at an approved pharmacy or supplier location.

Understanding Your Out-of-Pocket Costs

Even with Medicare coverage, beneficiaries will incur some out-of-pocket costs for blood glucose test strips. These costs are consistent with how Medicare Part B covers durable medical equipment. Individuals must first satisfy the annual Medicare Part B deductible before Medicare contributes to the cost of supplies. In 2025, the annual deductible for Medicare Part B is $257.

After the deductible is met, Medicare typically pays 80% of the Medicare-approved amount for blood glucose test strips and related DME. The beneficiary is responsible for the remaining 20% coinsurance. This cost-sharing applies when supplies are obtained from a Medicare-approved supplier who accepts assignment. Accepting assignment means the supplier agrees to accept Medicare’s approved amount as full payment and can only charge the beneficiary the deductible and coinsurance. If a supplier does not accept assignment, they may charge more than the Medicare-approved amount, and the beneficiary is responsible for the difference.

Medicare Supplement Insurance, also known as Medigap plans, can help reduce these out-of-pocket expenses. Medigap policies are sold by private insurance companies and cover costs not paid by Original Medicare, such as deductibles, copayments, and coinsurance. Many Medigap plans cover the Part B coinsurance, effectively reducing the beneficiary’s 20% share for blood glucose test strips.

For those enrolled in a Medicare Advantage (Part C) plan, the cost-sharing structure may differ from Original Medicare. Medicare Advantage plans must cover at least what Original Medicare covers, but they may have their own deductibles, copayments, and coinsurance amounts. Beneficiaries with a Medicare Advantage plan should contact their plan directly to understand specific costs and rules for obtaining blood glucose test strips, and any network requirements for suppliers.