Medicare covers most diabetic supplies, but the amount depends on your plan type and whether you use insulin

Medicare Part B pays for blood sugar testing supplies, lancets, and lancing devices for people with diabetes who take insulin or use certain other medications. If you have Type 2 diabetes managed by diet alone, Medicare does not cover these items. Part B also covers some diabetic shoes and inserts if a doctor certifies you have severe diabetic foot disease. Insulin itself is covered under Part D (prescription drug coverage), not Part B.

The coverage rules are strict about what counts as a covered supply and how often you can get replacements. A doctor must order the supplies, and you must use a Medicare-approved supplier. Costs vary: you typically pay 20 percent of the approved amount after you meet your Part B deductible, though some suppliers charge more than Medicare's approved rate.

Key Takeaways

  • Medicare Part B covers blood glucose monitors, test strips, lancets, and lancing devices only if you take insulin or use a sulfonylurea or meglitinide medication.
  • You need a written order from your doctor and must purchase from a Medicare-approved supplier to get coverage.
  • Medicare sets a limit on how many test strips and lancets you can receive per month, typically based on how often you test.
  • Insulin is covered under Part D (prescription drug plans), not Part B, so your out-of-pocket cost depends on your specific plan.
  • If you use a continuous glucose monitor, coverage rules differ and require prior authorization from your plan.

What Medicare Part B covers for diabetes

Part B covers blood glucose monitors (the device itself), test strips, lancets, and lancing devices. You must have a prescription from your doctor stating that you have diabetes and take insulin or use certain oral medications. The medications that may have access to are sulfonylureas (such as glyburide or glipizide) and meglitinides (such as repaglinide). If you manage your diabetes through diet and exercise alone, Part B does not cover these supplies.

Medicare also covers diabetic shoes and shoe inserts if a podiatrist or other may have access to doctor certifies that you have severe diabetic foot disease. This typically means you have a history of ulcers, amputation, or significant nerve damage in your feet. The coverage includes one pair of shoes and three pairs of inserts per year, or one pair of shoes with inserts built in.

Continuous glucose monitors (CGMs) are covered under Part B, but the rules are more complex. Your doctor must request prior authorization, and you must meet specific criteria. Coverage varies by plan, so contact your plan directly to learn whether a CGM is covered for you.

How to get your supplies through Medicare

First, ask your doctor to write a prescription for your diabetic supplies. The prescription must state your diagnosis, the type of diabetes, and the medication you take. Your doctor should also specify how often you test your blood sugar — this determines how many strips and lancets Medicare will cover per month.

Next, find a Medicare-approved supplier. You can search for suppliers on the Medicare website or call 1-800-MEDICARE. Not all pharmacies and medical supply companies are approved, so verify before you place an order. When you contact the supplier, give them your Medicare number and your doctor's prescription.

The supplier will bill Medicare directly. You will receive an Explanation of Benefits (EOB) in the mail showing what Medicare paid and what you owe. If you have not met your Part B deductible for the year, you pay the full approved amount until you reach it. After that, you typically pay 20 percent of the approved amount.

Monthly limits on test strips and lancets

Medicare limits the number of test strips and lancets you can receive each month. The limit is based on how many times per day your doctor says you need to test. If your doctor prescribes testing three times daily, Medicare covers up to 90 test strips and 90 lancets per month (3 tests × 30 days). If you test four times daily, the limit is 120 strips and 120 lancets.

These limits are firm. If you run out before the month ends, Medicare will not pay for additional strips until the next month begins. Some people order extra supplies out of pocket or ask their doctor to increase the prescribed testing frequency if they believe they need more. Keep in mind that changing your prescription requires a new order from your doctor.

If your testing needs change — for example, if you start insulin therapy or switch medications — ask your doctor to update your prescription. The new prescription will take effect once the supplier receives it.

What you pay out of pocket

Your out-of-pocket cost depends on whether you have met your Part B deductible and whether the supplier charges more than Medicare's approved amount. In 2024, the Part B deductible is $240. Once you meet it, you pay 20 percent of the Medicare-approved amount for your supplies.

Some suppliers charge more than Medicare's approved rate. When this happens, you may owe the difference. Before you order, ask the supplier what the Medicare-approved amount is and what you will pay out of pocket. This protects you from surprise bills.

If you have a Medigap or Medicare Advantage plan, your coverage may differ. Medigap plans may cover some or all of your 20 percent coinsurance. Medicare Advantage plans set their own rules for diabetic supplies, so check your plan documents or call your plan to learn your costs.

Insulin coverage under Part D

Insulin is a prescription medication covered under Part D, not Part B. Your out-of-pocket cost for insulin depends on your specific Part D plan. Most plans place insulin in a higher cost tier, meaning you pay more than you would for other medications.

Part D plans use a four-tier system. Insulin is often in Tier 3 or Tier 4, which typically cost $35 to $100 or more per prescription, depending on the plan and the type of insulin. Some plans offer insulin at a lower cost through preferred brands or generic versions.

If your insulin costs are high, you have options. You can ask your doctor about switching to a less expensive insulin, request a formulary exception from your plan, or switch to a different Part D plan during the annual enrollment period (October 15 to December 7). The Medicare website has a tool that lets you compare Part D plans and see the cost of your specific insulin in each plan.

Common mistakes to avoid

Do not order supplies without a current prescription from your doctor. Medicare will not pay for supplies ordered without one, and you will owe the full cost. Make sure your prescription includes your diagnosis, medication, and testing frequency.

Do not use a supplier that is not Medicare-approved. Even if the supplier is a pharmacy you know, they may not be approved for Medicare diabetic supplies. Verify approval before you order.

Do not assume your Medigap or Medicare Advantage plan covers diabetic supplies the same way Original Medicare does. Call your plan to learn your specific coverage and costs. Plans vary widely.

Do not ignore the monthly limits. If you test more often than your prescription allows, talk to your doctor about updating your order. Ordering extra supplies out of pocket and then trying to get Medicare to reimburse you will not work.

Frequently Asked Questions

Does Medicare cover diabetic supplies if I do not take insulin?

Medicare Part B covers supplies only if you take insulin or use a sulfonylurea or meglitinide medication. If you manage diabetes through diet, exercise, or other oral medications, Part B does not cover test strips or lancets. You would pay out of pocket or check whether your Part D plan covers a glucose monitor as a durable medical equipment benefit.

Can I use any pharmacy or supplier for my diabetic supplies?

No. You must use a Medicare-approved supplier. Not all pharmacies are approved for Medicare diabetic supplies. Search the Medicare website or call 1-800-MEDICARE to find an approved supplier near you. Using an unapproved supplier means Medicare will not pay, and you will owe the full cost.

What happens if I need more test strips than Medicare allows?

Medicare's monthly limits are based on your prescribed testing frequency. If you need more strips, ask your doctor to increase your prescription. Your doctor can update the order to reflect a higher testing frequency, and the new limit will explore going forward. Any strips beyond the approved amount must be paid out of pocket.

Does Medicare cover continuous glucose monitors?

Medicare Part B covers some CGMs, but coverage rules are complex and vary by plan. Your doctor must request prior authorization, and you must meet specific medical criteria. Contact your Medicare plan directly to find out whether a CGM is covered for you and what your out-of-pocket cost would be.

How much will I pay for insulin under Part D?

Part D costs vary by plan and insulin type. Most plans place insulin in Tier 3 or Tier 4, which typically cost $35 to $100 or more per prescription. Use the Medicare plan comparison tool on Medicare.gov to see the exact cost of your insulin in different Part D plans. You can switch plans during open enrollment if you find a plan with lower insulin costs.