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Medicare Coverage of Diabetic Supplies

Medicare Coverage of the Diabetic Glucose Monitor and Diabetic Supplies

Background

If you are a diabetic enrolled in Medicare Part B and your doctor has prescribed a home blood glucose monitor, you may qualify for Medicare reimbursement for the monitor and related diabetic supplies.

How to Qualify?

In order to qualify for reimbursement, you must be treated by a doctor for diabetes. Your doctor must also prescribe the home blood glucose monitor and determine that you or another responsible individual are capable of being trained to operate the device. If you have a severe visual impairment, you may qualify for Medicare reimbursement of a monitor with special features.

What is Covered?

If you have diabetes, and your doctor prescribes a home blood glucose monitor, Medicare Part B will help pay for the monitor, test strips, lancets, and a spring powered device for the lancets.

The store or supplier of your monitor, test strips, and lancets must be enrolled in the Medicare program and must submit a claim to Medicare for you. Medicare will not pay for supplies that you purchase from a store or source that is not an enrolled Medicare supplier and/or for claims for supplies that you submit yourself.

You can use the supplier search tool on www.medicare.govto find Medicare enrolled suppliers in your area, or you can call 1-800-MEDICARE (1-800-633-4227) for assistance.

If your test strips and lancets are delivered to your home, the supplier must contact you before sending more. The supplier should not automatically send them to you. You should only receive these supplies from one supplier.

If you use more test strips than are allowed by Medicare, you will need to see your doctor at least once every six months. Your doctor will need to evaluate your diabetes control. You will need to maintain a testing log to show how many times you are testing your blood. Maintaining a testing log is ONLY required when using more test strips than Medicare allows. However, it is recommended that you maintain a testing log even if you are NOT using more test strips than what Medicare allows.

If you are insulin treated, the maximum allowance (every three months):

300 test strips (3 times per day testing)
300 lancets (3 times per day testing)

If you are non?insulin treated, the maximum allowance (every three months):

100 test strips (1 time per day testing)
100 lancets (1 time per day testing)

The following diabetic items ARE NOT COVERED by Medicare Part B:

Items NOT covered:
- Insulin*
- Syringes*
- Alcohol
- Betadine
- Iodine wipes
- Peroxide
- Cotton swabs
- Alcohol wipes
- Betadine wipes
- Urine test strips
- Antibacterial skin cleanser

*Insulin and syringes may be covered under the Medicare Part D Drug Benefit. Insulin is also covered by the Medicare if it is administered through a medically necessary insulin pump.

Contacting Medicare

You can have your Medicare questions answered by calling 1-800-MEDICARE (1-800-633-4227) 24-hours a day; 7-days a week. You can speak to a live person either by saying the word “agent” or by "pressing zero" at any time during the call.

If you have access to the internet, you can visit www.medicare.gov, or you can register free at www.MyMedicare.gov to use a secure online service that allows access to your Medicare records and benefit information via the Internet.