Medicare Part B covers blood glucose test strips, but only if you use an FDA-approved meter and meet specific conditions
Medicare Part B pays for test strips as durable medical equipment — the same category as wheelchairs and oxygen. You need a prescription from your doctor, and Medicare will cover strips for the specific meter your doctor prescribes. The coverage is not automatic: you must be enrolled in Part B, and your doctor must document that you have diabetes and need regular blood glucose monitoring.
The amount Medicare pays depends on your meter. Some meters are covered at a higher rate than others. You pay 20 percent of the Medicare-approved amount after you meet your Part B deductible. If your meter costs more than the approved amount, you pay the difference out of pocket — this is called balance billing.
Coverage also depends on how often you test. Medicare sets limits on the number of strips it will pay for each month based on your diabetes type and whether you use insulin. If you test more frequently than Medicare's limit, you pay for the extra strips yourself.
Key Takeaways
- Your doctor must write a prescription for test strips and specify which meter brand you use; Medicare does not cover strips for meters without a prescription.
- Medicare covers strips only for FDA-approved meters, and the approved amount varies by meter model, so your out-of-pocket cost depends on which meter your doctor chooses.
- Monthly limits on strip coverage range from 50 to 100 strips depending on whether you use insulin and your diabetes type, and you pay full price for strips beyond that limit.
- You must have Part B active and meet your annual deductible before Medicare begins paying its share of the cost.
How Medicare decides what strips it will pay for
Medicare maintains a list of covered blood glucose meters and the test strips that work with them. Not every meter on the market is on this list. Your doctor can prescribe any meter, but Medicare will only pay for strips if the meter is on the covered list and your doctor's prescription names that specific meter.
The covered meters change periodically as manufacturers submit new models and old ones are discontinued. Common covered meters include models from OneTouch, Accu-Chek, and Contour, but you should not assume your meter is covered without checking. You can search the Medicare list of covered items at the Centers for Medicare & Medicaid Services (CMS) website, or ask your doctor's office to verify before you fill a prescription.
If your meter is not on the covered list, Medicare will not pay for the strips, even if your doctor prescribes them. In that case, you would need to pay the full cost yourself or switch to a covered meter.
Monthly limits on how many strips Medicare will pay for
Medicare sets a monthly limit based on your diabetes type and treatment. If you have Type 1 diabetes or Type 2 diabetes and use insulin, Medicare typically covers up to 100 test strips per month. If you have Type 2 diabetes and do not use insulin, the limit is usually 50 strips per month.
These limits are not negotiable, even if your doctor believes you need more strips. If you test more frequently than the limit allows, you pay the full cost of the extra strips. Some people with Type 1 diabetes or those using insulin pumps may find 100 strips per month insufficient, especially if they test before meals, after meals, before bed, and when they feel symptoms.
If you consistently exceed the limit, talk to your doctor about whether your testing pattern can be adjusted, or ask whether your insurance plan offers any other coverage options. Some Medigap plans or Part D plans may cover additional strips, though this is rare.
What you pay out of pocket
Your cost depends on three things: whether you have met your Part B deductible, the Medicare-approved amount for your meter's strips, and whether your strips cost more than that approved amount.
Once you meet your annual Part B deductible (which changes each year), Medicare pays 80 percent of the approved amount for test strips. You pay the remaining 20 percent. If the strips you buy cost more than Medicare's approved amount, you also pay the full difference — Medicare will not pay any part of that overage.
For example, if Medicare's approved amount for a box of 50 strips is $30, and you have met your deductible, Medicare pays $24 and you pay $6. If the same box costs $40 at your pharmacy, Medicare still pays only $24, and you pay $16 out of pocket.
Getting a prescription and ordering strips
Your doctor must write a prescription that names the specific meter brand and model. A generic prescription for "test strips" will not work. When you fill the prescription, tell the pharmacy that you have Medicare Part B so they can bill Medicare directly.
You can fill the prescription at any pharmacy — a chain pharmacy, an independent pharmacy, or a mail-order pharmacy. Some pharmacies specialize in diabetes supplies and may have more meter options in stock. Ask your pharmacy whether they accept Medicare assignment, which means they agree to accept Medicare's approved amount as payment in full (except for your 20 percent coinsurance). If they do not accept assignment, you may owe more.
If you order strips by mail, the process takes longer but may be cheaper if the mail-order pharmacy is in-network with Medicare. Ask your pharmacy or your doctor's office which option is available to you.
What happens if your meter is not covered or you exceed the monthly limit
If your meter is not on Medicare's covered list, you have two options: switch to a covered meter (with your doctor's approval) or pay out of pocket for your current meter's strips. Some people choose to pay out of pocket because they prefer their current meter or because their doctor believes it is medically necessary.
If you exceed the monthly limit, Medicare will not pay for the extra strips. You can still buy them, but you pay the full pharmacy price. Some people use a combination approach: they buy the Medicare-covered strips up to the limit and then purchase additional strips from a discount program or a different brand to keep costs down.
If you believe you need more strips than Medicare's limit allows, ask your doctor to document the medical reason in your chart. While this does not change Medicare's policy, it creates a record that may help if you appeal or if you switch to a different insurance plan.
Frequently Asked Questions
Does Medicare Part D cover test strips?
Part D is prescription drug coverage and does not typically cover test strips because Medicare classifies them as durable medical equipment, not drugs. Part B is the correct coverage. However, some Part D plans may cover lancets (the small needles used to prick your finger), so check your plan documents.
What if I use a continuous glucose monitor instead of a meter?
Continuous glucose monitors (CGMs) are covered under Part B as durable medical equipment, but the coverage rules are different from test strips. You need a prescription, and Medicare covers certain approved models. The sensors and transmitters are covered, but you may have a higher out-of-pocket cost than with test strips.
Can I get test strips without a prescription?
You can buy test strips without a prescription at any pharmacy, but Medicare will not pay for them. You would pay the full retail price. Medicare requires a prescription because it is a condition of coverage — the prescription documents that your doctor believes you need regular monitoring.
What if my pharmacy says Medicare will not pay?
Ask the pharmacy to check whether your meter is on the Medicare covered list and whether you have met your deductible. If your meter is covered and your deductible is met, the pharmacy may have entered incorrect information. If your meter is not covered, ask your doctor whether you can switch to a covered meter, or ask the pharmacy about the cash price.
Do I need to reorder strips every month or can I stock up?
Medicare limits coverage to a specific number of strips per month, so you cannot stock up beyond that limit and have Medicare pay for it. You can order once a month or split orders across the month, but Medicare will not cover more than the monthly limit regardless of when you order.