Medicare covers some diabetic supplies, but not all, and the coverage depends on which part of Medicare you have and whether your doctor says the item is medically necessary

Medicare Part B covers blood glucose monitors, test strips, lancets, and lancing devices if you have diabetes and your doctor prescribes them. Medicare Part D (prescription drug coverage) covers insulin and some diabetes medications. Durable medical equipment like continuous glucose monitors and insulin pumps may be covered under Part B, but you will typically pay 20 percent of the cost after you meet your deductible. Supplies like syringes, alcohol swabs, and glucose tablets are usually not covered.

The exact items covered and how much you pay depend on your specific plan and whether the item meets Medicare's definition of medically necessary. Some items require prior approval from Medicare before your doctor can prescribe them. If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower than Original Medicare.

Key Takeaways

  • Medicare Part B covers blood glucose monitors, test strips, and lancets when prescribed by your doctor, but you pay 20 percent of the approved amount after your deductible.
  • Insulin and most diabetes medications are covered under Medicare Part D, though you may have a copay or coinsurance depending on your plan's formulary.
  • Continuous glucose monitors and insulin pumps may be covered as durable medical equipment, but many require prior authorization from Medicare before your doctor prescribes them.
  • Supplies like syringes, alcohol swabs, and glucose tablets are typically not covered by any part of Medicare.
  • Your actual out-of-pocket costs depend on your plan type — Original Medicare, Medicare Advantage, or Medigap — and whether you have met your deductible.

What Medicare Part B Covers for Diabetes

Medicare Part B covers blood glucose monitors and the supplies that go with them: test strips, lancets, and lancing devices. Your doctor must write an order saying you need these items, and Medicare will cover 80 percent of the approved amount after you meet your Part B deductible (which is $240 in 2024, though this changes yearly). You pay the remaining 20 percent.

To get these supplies covered, you will need to use a Medicare-approved supplier. Your doctor can help you find one, or you can search the Medicare supplier directory on Medicare.gov. The supplier will submit the claim to Medicare on your behalf. You should receive your supplies within a few days to a week after Medicare approves the order.

Continuous glucose monitors (CGMs) like the Dexcom or FreeStyle Libre are covered as durable medical equipment under Part B, but Medicare requires prior authorization. This means your doctor must submit a request to Medicare before you order the device, and Medicare must approve it first. The approval process usually takes one to two weeks. Once approved, you pay 20 percent of the approved amount after your deductible.

Insulin Pumps and How Medicare Covers Them

Insulin pumps are covered under Medicare Part B as durable medical equipment. Like CGMs, they require prior authorization from Medicare before your doctor can prescribe them. Your doctor will need to document that you have tried insulin injections first and that the pump is medically necessary for your care.

The prior authorization process for a pump typically takes two to four weeks. Once approved, Medicare covers 80 percent of the approved amount, and you pay 20 percent after your deductible. You will also need to use a Medicare-approved supplier to obtain the pump. Pump supplies like infusion sets and reservoirs are usually covered under the same 80/20 split.

Some Medicare Advantage plans cover insulin pumps with lower out-of-pocket costs than Original Medicare, so it is worth checking your plan documents or calling your plan's customer service before starting the prior authorization process.

Insulin and Diabetes Medications Under Part D

Insulin and most diabetes medications are covered under Medicare Part D, which is prescription drug coverage. Part D is optional, and you must enroll during your initial enrollment period or during the annual open enrollment period (October 15 to December 7 each year). If you do not enroll when you are first may be able to access and do not have other creditable drug coverage, you may pay a late enrollment penalty.

Each Part D plan has a formulary, which is a list of covered drugs. Insulin is on every formulary, but the specific types and brands covered vary by plan. Some plans cover all insulins; others require you to try a cheaper insulin first before they will cover a more expensive one. Your copay or coinsurance for insulin depends on which tier it is on in your plan's formulary — typically $0 to $35 per month for a 30-day supply, though this varies.

Other diabetes medications like metformin, GLP-1 agonists (such as Ozempic or Trulicity), and SGLT2 inhibitors are also covered under Part D, but again the exact copay depends on your plan. You can compare Part D plans on Medicare.gov during open enrollment to find the one with the lowest cost for your specific medications.

Supplies Medicare Does Not Cover

Medicare does not cover syringes, alcohol swabs, cotton balls, or other disposable items used to inject insulin or prick your finger. These are considered routine supplies rather than durable medical equipment. You will need to buy them out of pocket or through a pharmacy discount program.

Glucose tablets, gel, or other fast-acting carbohydrates used to treat low blood sugar are also not covered. Some people find these items at a lower cost through big-box retailers like Walmart or Costco, or through online pharmacies. Your local pharmacy may also offer a discount if you ask.

Diabetic shoes and shoe inserts are covered under Medicare Part B only if you have diabetes and your doctor documents that you have severe diabetic foot disease. This is a separate benefit with its own rules, and most routine foot care is not covered.

How to Order Covered Supplies Through Medicare

The process for ordering covered diabetic supplies is the same whether you have Original Medicare or Medicare Advantage. First, your doctor writes an order for the item and specifies how often you need it (for example, "test strips, 4 times daily"). Your doctor will either give you the order or send it directly to a Medicare-approved supplier.

Next, you contact a Medicare-approved supplier or your doctor can refer you to one. The supplier will verify that you have Medicare coverage and that the item is covered under your plan. For items that require prior authorization (like CGMs or pumps), the supplier will submit the authorization request to Medicare on your behalf. You should not have to do this yourself.

Once Medicare approves the order, the supplier will ship the supplies to you. For ongoing supplies like test strips, you can set up automatic refills so you do not run out. Keep track of when your supplies arrive and contact the supplier if anything is missing or damaged.

Medicare Advantage Plans and Diabetic Supplies

Medicare Advantage plans (Part C) must cover everything that Original Medicare covers, but they often have lower out-of-pocket costs for diabetic supplies. Some Medicare Advantage plans cover all test strips and lancets with no copay, while others charge a small copay. Some plans also cover items that Original Medicare does not, such as glucose tablets or certain over-the-counter diabetes products.

Check your plan's formulary and coverage documents to see what diabetic supplies are covered and what you will pay. If your plan's coverage changes or you find that your supplies are not covered, you can switch to a different Medicare Advantage plan or to Original Medicare during the annual open enrollment period (October 15 to December 7).

If you use a Medicare Advantage plan, you still need to use a Medicare-approved supplier for durable medical equipment like pumps and CGMs, but the supplier will submit claims to your Medicare Advantage plan instead of to Original Medicare.

Frequently Asked Questions

Do I have to pay anything out of pocket for test strips and lancets?

Under Original Medicare Part B, you pay 20 percent of the approved amount after you meet your $240 annual deductible. Under Medicare Advantage, your copay depends on your specific plan — some plans charge nothing, while others charge $5 to $15 per box. Check your plan documents or call your plan's customer service to find out your exact cost.

What if my doctor prescribes a CGM but Medicare denies the prior authorization?

If Medicare denies the authorization, your doctor can appeal the decision or request a reconsideration. You have the right to request a detailed explanation of why Medicare denied it. Your doctor may need to provide additional medical documentation showing that you have tried other glucose monitoring methods first or that the CGM is medically necessary for your specific situation.

Can I buy diabetic supplies from any pharmacy or do I have to use a Medicare-approved supplier?

For items like test strips and lancets, you can use any pharmacy, but Medicare will only pay if the pharmacy is a Medicare-approved supplier. If you use a non-approved supplier, Medicare will not cover the cost and you will pay the full price. For durable medical equipment like pumps and CGMs, you must use a Medicare-approved supplier or Medicare will not cover it.

Does Medicare cover diabetic eye exams or foot care?

Medicare Part B covers one diabetic eye exam per year if you have diabetes. Routine foot care is not covered, but if you have severe diabetic foot disease, your doctor may be able to refer you for covered foot care. Diabetic shoes and inserts are covered only if you have documented severe diabetic foot disease and your doctor prescribes them.

What happens to my diabetic supplies if I switch from Original Medicare to Medicare Advantage?

Your coverage may change, so contact your new Medicare Advantage plan before the switch takes effect to confirm which supplies are covered and what you will pay. If you have an ongoing supply order with a Medicare-approved supplier, notify the supplier of your plan change so they can bill the correct plan. You may need to restart the prior authorization process for items like CGMs or pumps under your new plan.