Medicare Part B covers glucometers and test strips, but only if your doctor says you need them to manage diabetes

Yes, Medicare Part B covers blood glucose monitors (glucometers) and the test strips that go with them. You pay 20% of the cost after you meet your Part B deductible, and the supplier pays the rest. The catch is that your doctor must write an order saying you have diabetes and need to check your blood sugar at home — Medicare will not pay for a monitor without that paperwork.

The coverage applies whether you take insulin or manage your diabetes with pills or diet alone. Medicare considers home blood glucose monitoring medically necessary for anyone with a diabetes diagnosis. You do not need to be on insulin specifically, though people on insulin are the most common users.

Key Takeaways

  • Your doctor must write an order for a glucometer before Medicare will pay; you cannot buy one on your own and ask for reimbursement later.
  • Medicare Part B pays 80% of the approved amount for the monitor and test strips after your deductible, and you pay 20%.
  • You must use a Medicare-approved supplier, and the supplier handles the paperwork with Medicare directly.
  • Test strips are covered as long as your doctor's order is current, but you may need a new order every year or when your diabetes management changes.
  • Lancets (the small needles used to prick your finger) are also covered under the same rules as test strips.

How to get your glucometer through Medicare

Start by talking to your doctor or diabetes educator. Tell them you want to monitor your blood sugar at home and ask them to send an order to a Medicare-approved supplier. The order needs to say what type of monitor you need and how often you should check your blood sugar (for example, "four times daily" or "twice daily"). Your doctor does not need to write a prescription — a written order from their office is enough.

Once you have the order, contact a Medicare-approved supplier. You can find one by calling Medicare at 1-800-MEDICARE or searching the Medicare Supplier Directory online. Tell the supplier you have a doctor's order and ask what your out-of-pocket cost will be. The supplier will verify your coverage, collect your 20% coinsurance, and ship the monitor and initial test strips to your home. The supplier files the claim with Medicare on your behalf.

The whole process usually takes one to two weeks. You do not need to pay anything upfront if the supplier agrees to bill Medicare directly, which most do.

What Medicare pays for and what it does not

Medicare Part B covers the glucometer itself (the device), test strips, lancets, and lancing devices (the spring-loaded tool that holds the lancet). All of these are considered durable medical equipment or supplies under Medicare rules. You pay 20% coinsurance on each item after your Part B deductible.

Medicare does not cover continuous glucose monitors (CGMs) — the small sensors you wear on your skin that send readings to a phone or watch — under the standard Part B rules. However, some Medicare Advantage plans do cover CGMs, and Medicare Part B has begun covering them for people on insulin who meet specific requirements. Ask your doctor or call Medicare to learn about you may have access to for a CGM.

Medicare also does not cover lancets or test strips if you buy them over the counter without a doctor's order, even if you have diabetes. The order is what makes them a covered benefit.

The cost you will pay

Your cost depends on the approved amount Medicare sets for each item and whether you have met your Part B deductible for the year. The Part B deductible for 2024 is $240, though this amount changes each year. Once you meet the deductible, you pay 20% of the approved amount for the monitor and all supplies.

A typical glucometer approved by Medicare costs between $40 and $100, so your 20% share might be $8 to $20. Test strips are usually $0.50 to $1.50 per strip after your coinsurance, depending on the brand and the approved amount. If you check your blood sugar four times a day, you might use 120 strips a month, which could cost $60 to $180 out of pocket.

These are estimates based on common approved amounts, but the exact cost varies by supplier and by the specific products Medicare approves. Ask the supplier for a cost estimate before you place an order.

Medicare Advantage plans and glucometer coverage

If you have a Medicare Advantage plan (Part C), your coverage for glucometers and test strips may be different from Original Medicare. Some Advantage plans cover these supplies with a lower copay or coinsurance than Original Medicare, and some cover them with no cost to you. Other plans follow the same 20% coinsurance rule as Original Medicare.

Check your plan's formulary or call the plan directly to find out what you pay for a glucometer and test strips. You still need a doctor's order, and you still must use a plan-approved supplier. If your plan covers the supplies differently than Original Medicare, the plan's rules explore.

When you need a new order or a new monitor

Your doctor's order for a glucometer is usually good for one year. If you run out of test strips before the year is up, you can ask the supplier to send more — you do not need a new order for refills. However, if your diabetes management changes (for example, if you start taking insulin when you were not before), your doctor may write a new order for a different type of monitor or a higher frequency of testing.

Medicare allows you to get a new glucometer every five years under normal circumstances. If your monitor breaks or stops working, talk to your supplier about whether Medicare will pay for a replacement before the five-year mark. Some suppliers will replace a broken monitor sooner if you document the damage.

What to do if Medicare denies your claim

If the supplier tells you Medicare denied the claim, ask the supplier why. Common reasons include: no doctor's order on file, the order is too old, the supplier is not Medicare-approved, or the monitor is not on Medicare's approved list. The supplier can usually fix these problems and resubmit the claim.

If the denial stands, you have the right to appeal. Ask the supplier for a copy of the denial letter, which will explain the reason and tell you how to file an appeal. You can also call Medicare at 1-800-MEDICARE to ask why the claim was denied and what you can do next. Appeals can take several weeks, so ask the supplier if they will send you supplies in the meantime.

Frequently Asked Questions

Do I need to be on insulin to get a glucometer covered by Medicare?

No. Medicare covers glucometers for anyone with a diabetes diagnosis, whether you take insulin, pills, or manage your diabetes through diet and exercise alone. Your doctor just needs to write an order saying you have diabetes and need to monitor your blood sugar at home.

Can I use my own glucometer and ask Medicare to reimburse me?

No. Medicare will not reimburse you for a glucometer you bought on your own. You must have a doctor's order before you buy it, and you must buy it from a Medicare-approved supplier. The supplier handles the Medicare claim directly.

What if my doctor says I do not need to check my blood sugar at home?

If your doctor does not think home monitoring is medically necessary, they will not write an order, and Medicare will not pay. You can buy a glucometer out of pocket, or you can ask your doctor to explain why they think home monitoring is not needed. Some people benefit from checking even if their doctor did not initially recommend it.

Will Medicare cover a continuous glucose monitor instead of a regular glucometer?

Medicare Part B coverage for continuous glucose monitors is limited and requires meeting specific criteria, usually related to insulin use. Medicare Advantage plans vary — some cover them and some do not. Ask your doctor or your plan whether you may have access to for a CGM.

How often can I get new test strips?

Your doctor's order specifies how many test strips you need per day. The supplier will send enough for that amount each month. If your testing needs change, ask your doctor to update the order. Medicare does not limit how many strips you can receive as long as your doctor's order supports the amount.