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

Medicare Part B pays for blood glucose test strips as durable medical equipment — the same category that covers wheelchairs and oxygen. You do not pay anything out of pocket once you meet your Part B deductible, and then you pay 20 percent of the approved amount. The catch is that Medicare will only pay if a doctor has documented that you have diabetes and prescribed the strips as medically necessary.

The strips themselves are not the issue. The documentation is. Your doctor must write an order that goes to a Medicare-approved supplier, not just any pharmacy or online retailer. Medicare keeps a list of approved suppliers by state, and using one outside that list means Medicare will not pay, even if the supplier seems legitimate.

How much you pay depends on your specific plan. If you have Original Medicare (Part A and B), you pay 20 percent after your deductible. If you have a Medicare Advantage plan, your cost-sharing may be different — some plans cover strips with a small copay, others with coinsurance. Check your plan documents or call the number on your card to find out what your plan charges.

Key Takeaways

  • Your doctor must write a prescription and send it to a Medicare-approved supplier for Medicare to pay.
  • With Original Medicare, you pay 20 percent of the approved amount after you meet your Part B deductible.
  • Medicare Advantage plans have different cost-sharing rules, so check your plan's coverage before ordering.
  • Ordering from a pharmacy or retailer not on Medicare's approved supplier list means you pay the full cost yourself.
  • Medicare covers strips for type 1 diabetes, type 2 diabetes, and gestational diabetes if your doctor prescribes them.

How to order strips through Medicare

Start by asking your doctor to write a prescription for glucose test strips and specify how many you need per day. Your doctor will send the prescription to a Medicare-approved supplier, or you can ask your doctor's office which supplier they work with. Do not order from Amazon, Walmart, or a local pharmacy unless you have confirmed that supplier is on Medicare's approved list for your state.

Find the approved supplier list on Medicare.gov by searching "durable medical equipment suppliers" and selecting your state. Call the supplier to confirm they accept your insurance and to ask about delivery time. Most suppliers ship within a few days. When the strips arrive, check that the quantity matches your prescription — Medicare limits the number of strips based on how often your doctor says you need to test.

Keep your prescription and the supplier's paperwork. If Medicare denies the claim or charges you more than 20 percent, you will need these documents to file an appeal or to show the supplier made an error.

What happens if your doctor has not prescribed strips

If you have diabetes but your doctor has not given you a prescription for test strips, call your doctor's office and ask for one. Explain that you are checking your blood sugar at home and need strips. Your doctor does not need to see you in person to write this prescription — a phone call or message through the patient portal is usually enough.

If your doctor refuses or says strips are not necessary, you have options. You can ask to see an endocrinologist (a diabetes specialist) who may be more familiar with home testing. You can also ask your doctor in writing to document why they believe strips are not medically necessary — this creates a record if you need to appeal a Medicare denial later. Some people find it helpful to bring a log of their blood sugar readings to show their doctor why testing matters to them.

Medicare Advantage plans and glucose strips

If you have a Medicare Advantage plan (also called Part C), your coverage for glucose strips may be different from Original Medicare. Some Advantage plans cover strips with a copay as low as $5 to $10 per box. Others use coinsurance, meaning you pay a percentage. A few plans do not cover strips at all, or they cover them only if you use a specific brand or supplier.

Call the customer service number on your Advantage plan card and ask: "What is my cost-sharing for glucose test strips?" and "Do I have to use a specific supplier?" Write down the answer and the name of the person you spoke with. If the plan tells you strips are not covered, ask them to send you that information in writing, because some plans cover strips under different names (like "blood glucose monitoring supplies").

If your Advantage plan does not cover strips well, you may be able to switch to Original Medicare during the annual open enrollment period (October 15 to December 7 each year). This is one of the few times you can change plans without a penalty.

Cost-sharing and your deductible

With Original Medicare Part B, you have an annual deductible. Once you pay that deductible, Medicare pays 80 percent of the approved amount for glucose strips, and you pay 20 percent. The approved amount is set by Medicare, not by the supplier's list price. If a supplier charges $100 for a box of strips but Medicare's approved amount is $50, you pay 20 percent of $50, not 20 percent of $100.

If you have not met your Part B deductible yet this year, you will pay the full cost of the strips until you do. After that, you pay only 20 percent. Some people spread out their durable medical equipment purchases across the year to manage their deductible spending.

If you have a Medigap plan (supplemental insurance), it may cover some or all of your 20 percent cost-sharing. Check your Medigap plan documents or call the insurance company to see what they cover for durable medical equipment.

What to do if Medicare denies the claim

If you receive a bill from the supplier or a denial notice from Medicare, do not ignore it. Read the denial letter carefully — it will say why Medicare did not pay. Common reasons include: the supplier was not on the approved list, your doctor's prescription was incomplete, or Medicare determined the strips were not medically necessary.

If the supplier was not approved, contact Medicare at 1-800-MEDICARE and ask them to review the claim. If your doctor's prescription was incomplete, ask your doctor to send an updated one. If Medicare says the strips are not medically necessary, you can file an appeal. You have 120 days from the date on the denial letter to appeal. Include a letter from your doctor explaining why you need the strips, along with copies of your blood sugar logs if you have them.

If you believe the supplier made an error (for example, they billed Medicare for more strips than your prescription allowed), contact the supplier first and ask them to correct the claim. If they do not, contact Medicare's Office of Inspector General at 1-800-MEDICARE to report the issue.

Continuous glucose monitors versus test strips

A continuous glucose monitor (CGM) is a small device you wear on your skin that checks your blood sugar automatically throughout the day. Medicare covers some CGMs for people with diabetes who use insulin. If you use a CGM, you may not need test strips as often, or at all.

CGMs are more expensive upfront than strips, but Medicare may cover them if your doctor prescribes one and you meet the requirements. Ask your doctor whether a CGM might be right for you. If your doctor prescribes a CGM, the same rules explore: it must come from a Medicare-approved supplier, and you pay 20 percent after your deductible.

Frequently Asked Questions

Do I need a prescription every time I reorder strips?

No. Your doctor writes one prescription that specifies how many strips you need per day. The supplier uses that prescription to send you refills automatically, usually monthly. If your testing needs change, ask your doctor to write a new prescription with the updated quantity.

Can I use my Part D prescription drug plan to cover glucose strips instead of Part B?

No. Medicare Part D does not cover glucose test strips. They are covered only under Part B as durable medical equipment. If a pharmacy tries to bill your Part D plan for strips, ask them to bill Medicare Part B instead.

What if I want a specific brand of strips that is not on the approved supplier list?

You can buy that brand yourself and pay out of pocket, or you can ask your doctor to write a prescription for that specific brand and contact a Medicare-approved supplier to see if they carry it. Some suppliers stock multiple brands. If no approved supplier carries your preferred brand, Medicare will not pay for it.

Does Medicare cover strips if I have prediabetes?

Medicare covers strips only if you have been diagnosed with diabetes (type 1, type 2, or gestational). If your doctor has diagnosed you with prediabetes, Medicare does not cover strips. Ask your doctor whether home testing would help you manage your condition, and discuss whether you might be a candidate for a diabetes diagnosis.

What if I am on Medicare and Medicaid at the same time?

If you have both Medicare and Medicaid, Medicare is your primary payer for glucose strips. Medicaid may cover your cost-sharing (the 20 percent you owe after Medicare pays). Contact your state Medicaid office to ask what they cover for people who have both programs.