What Medicare Covers for Diabetic Test Strips and Glucose Monitoring

Medicare Part B covers diabetic test strips, but only if your doctor prescribes them and you meet specific requirements

Medicare Part B pays for blood glucose test strips as durable medical equipment (DME), the same category that covers wheelchairs and oxygen tanks. The program covers strips for people with diabetes who use insulin or certain oral medications. However, Medicare does not cover strips for everyone with diabetes — the rules depend on how you manage your condition and whether your doctor has written an order.

The amount Medicare pays varies. Medicare typically covers 100 test strips per month for people using insulin, and fewer for those managing diabetes without insulin. You pay 20 percent of the approved amount after you meet your Part B deductible. The actual out-of-pocket cost depends on which DME supplier you use, because suppliers can charge different prices within Medicare's approved range.

Getting coverage requires a written order from your doctor, not just a prescription you fill at a pharmacy. This is a key difference — your doctor must specifically order diabetic supplies through the DME process, and you must use a Medicare-approved DME supplier to get the coverage.

Key Takeaways

Medicare Part B covers test strips for people with diabetes who use insulin or take certain diabetes medications, but your doctor must write a DME order, not a regular prescription.
Medicare typically covers 100 strips per month for insulin users and a lower amount for non-insulin users, though your doctor can request more if medically necessary.
You pay 20 percent of the Medicare-approved amount after your Part B deductible, and the actual cost depends on which DME supplier you choose.
You must use a Medicare-approved DME supplier; strips purchased at a pharmacy or from a non-approved supplier will not be covered by Medicare.
If your doctor does not order strips through DME, Medicare will not pay, even if you have a regular prescription.

Who Medicare covers for test strips

Medicare covers test strips for people with diabetes who meet one of these conditions: you use insulin, you take a sulfonylurea or meglitinide medication (classes of oral diabetes drugs), or your doctor documents that you need strips for medical reasons. If you manage your diabetes through diet and exercise alone, or take only metformin or other medication classes, Medicare typically does not cover strips.

The coverage decision rests with your doctor. Medicare does not make the information — your doctor decides whether you need strips and writes the DME order. If your doctor believes you need strips even though you do not fit the standard categories, they can request an exception, though Medicare may deny it.

If you have Medicare Advantage (Part C), coverage rules may differ from Original Medicare. Some Advantage plans cover more strips or cover people in different medication categories. You should check your plan's formulary or call the plan directly to confirm what it covers.

How to get Medicare to pay for test strips

The process has four steps. First, ask your doctor to write a DME order for test strips — not a pharmacy prescription, but a specific order for durable medical equipment. Your doctor's office will have the form or know how to submit the order. Second, your doctor sends the order to a Medicare-approved DME supplier. You can ask your doctor which suppliers they work with, or you can find suppliers yourself through the Medicare DME supplier directory on Medicare.gov.

Third, the DME supplier confirms with Medicare that you meet the coverage rules and that your doctor's order is valid. This step usually takes a few days. Fourth, once approved, the supplier ships the strips to you and bills Medicare directly. You receive an explanation of benefits (EOB) showing what Medicare paid and what you owe.

The entire process typically takes one to two weeks from the time your doctor submits the order. If the supplier or Medicare denies the order, you will receive a notice explaining why. Common reasons for denial include: your doctor did not write a DME order, you do not meet the medication requirements, or the supplier is not Medicare-approved.

What you pay out of pocket

You pay 20 percent of the Medicare-approved amount for test strips after you have met your Part B deductible for the year. The Medicare-approved amount varies by supplier and region, but it is the maximum amount Medicare will pay. If a supplier charges more than the approved amount, you do not pay the difference — the supplier absorbs it.

For example, if the Medicare-approved amount is $50 per month for your strips and you have already met your deductible, you pay $10 and Medicare pays $40. If you have not met your deductible, you pay the full approved amount until the deductible is satisfied, then you pay 20 percent.

If you have a Medigap or Medicaid plan in addition to Medicare, that plan may cover some or all of your 20 percent cost-share. Medicaid rules vary by state, so contact your state Medicaid office to confirm what it covers.

Monthly limits and requesting more strips

Medicare sets a standard monthly quantity: 100 test strips per month for people using insulin, and 100 strips per month for people using certain oral medications. If you use multiple insulin injections daily or have unstable blood sugar, you may need more than 100 strips per month.

Your doctor can request a higher quantity by submitting a written justification to Medicare through the DME supplier. The justification should explain why the standard amount is not medically sufficient — for example, "patient uses insulin pump and checks blood sugar six times daily." Medicare reviews the request and either approves the higher amount or denies it. If denied, you can appeal.

Do not assume the standard amount is all you can receive. If your actual testing needs are higher, ask your doctor to request more. The worst outcome is that Medicare says no; the best outcome is that you get the strips you need covered.

Continuous glucose monitors and other devices

Medicare also covers continuous glucose monitors (CGMs) like Dexcom and FreeStyle Libre for people who use insulin. CGM coverage follows similar rules to test strips — your doctor must write a DME order, you use a Medicare-approved supplier, and you pay 20 percent after your deductible. Some CGMs are covered under Part B as DME; others may be covered under Part D as a drug or supply.

Lancets (the small needles used to prick your finger) and lancing devices are also covered under Part B. Glucose meters themselves are covered, though Medicare typically covers only one meter per year unless your doctor documents that you need a replacement sooner.

If you use a CGM, you may still need test strips for backup testing or to confirm CGM readings. Ask your doctor whether Medicare will cover both at the same time.

What to do if Medicare denies your order

If a DME supplier or Medicare denies your order for test strips, you will receive a notice called an Explanation of Benefits (EOB) or a Notice of Non-Coverage. The notice will state the reason for the denial. Common reasons include: your doctor did not write a DME order, you do not meet the medication requirements, the supplier is not Medicare-approved, or the quantity requested exceeds Medicare's limits.

You have the right to appeal. The appeal process has multiple levels. First, ask the DME supplier to resubmit the order with additional information — for example, if the denial was because your medication class was not recognized, your doctor can clarify which medication you take. If the supplier will not resubmit, you can file an appeal directly with Medicare within 120 days of the denial notice.

To appeal, contact Medicare at 1-800-MEDICARE or submit a written appeal to your local Medicare Administrative Contractor (MAC). Include a copy of the denial notice, your doctor's order, and any additional medical information that supports your need for strips. The appeal process can take several weeks.

Frequently Asked Questions

Can I buy test strips at a pharmacy and have Medicare pay me back?

No. Medicare only pays when you use a Medicare-approved DME supplier. If you buy strips at a pharmacy or from a non-approved supplier, Medicare will not reimburse you, even if you have a prescription. You must go through the DME process to receive coverage.

What if my doctor says I need more than 100 strips per month?

Your doctor can request a higher quantity by submitting a written justification to Medicare through your DME supplier. Include details about your testing schedule and why the standard amount is insufficient. Medicare will review and approve or deny the request. If denied, you can appeal.

Does Medicare Advantage cover test strips the same way?

No. Medicare Advantage plans set their own coverage rules and may cover more strips, fewer strips, or different people than Original Medicare does. Check your plan's formulary or call the plan to confirm what it covers before you ask your doctor for an order.

What if I have both Medicare and Medicaid?

Medicaid may cover some or all of your 20 percent cost-share, depending on your state. Contact your state Medicaid office to confirm what it covers. If Medicaid covers the cost-share, tell the DME supplier so it can bill Medicaid after Medicare pays.

Do I need a new DME order every month?

No. Your doctor writes one DME order that typically covers 12 months of supplies. The DME supplier will ship strips to you monthly or in bulk, depending on what your doctor ordered. If your needs change, your doctor can write a new order.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.