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. The program covers the strips themselves, the lancing devices that prick your finger, and the lancets (the small needles). What Medicare does not cover is the glucose meter (the device that reads the strip), though some meters cost under $20 and many manufacturers offer them free when you buy their strips.

The catch is that Medicare only pays if your doctor writes an order saying you need the strips. You cannot walk into a pharmacy and buy them on your own; the prescription has to come from your doctor, nurse practitioner, or physician assistant. Medicare also limits how many strips you can receive per month based on how often your doctor says you need to test.

If you use insulin or certain diabetes medications, Medicare is more likely to cover strips at a higher frequency. If you manage diabetes with diet and oral medication alone, Medicare may cover fewer strips per month, or may not cover them at all — this depends on your specific situation and what your doctor documents.

Key Takeaways

  • Your doctor must write a prescription for glucose test strips; Medicare will not pay for strips you buy on your own.
  • Medicare Part B covers the strips, lancets, and lancing devices, but typically not the glucose meter itself.
  • The number of strips Medicare covers per month depends on your diabetes type, medications, and what your doctor prescribes.
  • You pay 20 percent of the Medicare-approved amount after you meet your Part B deductible; there is no coverage limit once you reach Part D catastrophic coverage if you also use insulin.
  • If your doctor's prescription is denied, you can ask your doctor to appeal or to resubmit with more detail about why you need that frequency of testing.

How to get Medicare to pay for your strips

Start by talking to your doctor about how often you test your blood sugar. If you test daily or multiple times a day, tell your doctor that and ask them to write an order for test strips. Your doctor will specify the quantity per month — for example, "100 test strips per month" or "three times daily." Bring this written order to your pharmacy.

Your pharmacy will submit the order to Medicare for approval. This usually takes a few days. Medicare will check whether the quantity matches national guidelines for your type of diabetes and medications. If it does, Medicare approves it and you pay your 20 percent coinsurance. If Medicare thinks the quantity is too high, they may deny it or approve a lower amount.

Keep a copy of your doctor's order and the Medicare approval letter. If you need to refill before the month is up because you test more often than expected, your doctor can request an increase in the monthly quantity, but this requires a new order and a new Medicare review.

What Medicare considers "medically necessary" testing frequency

Medicare has national guidelines for how many strips per month are reasonable based on your diabetes management. If you use insulin, Medicare typically covers up to 100 strips per month (about three per day). If you use certain oral medications like sulfonylureas, Medicare may cover 50 to 100 strips per month. If you manage diabetes with diet and metformin alone, Medicare may cover fewer strips or none, depending on whether your doctor documents that you need frequent monitoring.

These are guidelines, not absolute rules. Your doctor can request more strips if they document a medical reason — for example, if you are newly diagnosed, adjusting medications, or having trouble controlling your blood sugar. The key is that your doctor has to explain why you need that frequency in the order itself or in a note to Medicare.

If Medicare denies your prescription as not medically necessary, your doctor can file an appeal. This is called a redetermination. Your doctor writes a letter explaining why you need that quantity of strips, and Medicare reviews it again. This process takes about two weeks.

Your out-of-pocket costs

Once Medicare approves your strips, you pay 20 percent of the Medicare-approved amount. The approved amount varies by region and by brand, but test strips typically cost Medicare $0.50 to $1.50 per strip after negotiation. That means your 20 percent coinsurance is usually $0.10 to $0.30 per strip.

If you have not yet met your Part B deductible for the year, you pay the full approved amount until you reach $240 (the 2024 deductible; this amount changes yearly). After you meet the deductible, you pay 20 percent for the rest of the year.

If you also have a Medigap or Medicare Advantage plan, that plan may cover some or all of your 20 percent coinsurance. Check your plan documents or call the plan to ask what they cover for glucose test strips.

If your doctor's prescription is denied

If Medicare denies your prescription, your pharmacy will send you a notice called an Explanation of Benefits (EOB). This notice explains why Medicare said no — usually because the quantity is higher than their guidelines for your situation, or because your doctor did not document a medical reason.

You have three options. First, you can ask your doctor to resubmit the order with a note explaining why you need that frequency — for example, "patient is newly diagnosed and adjusting insulin doses" or "patient has frequent hypoglycemic episodes and needs to monitor closely." Second, your doctor can request a redetermination, which is Medicare's formal appeal process. Third, you can pay out of pocket for the strips while the appeal is pending; if Medicare eventually approves them, you may be able to get reimbursed, though this is not may provide.

The redetermination process takes about two weeks. Your doctor submits a written request to the Medicare contractor in your state, along with medical records or a letter explaining the medical necessity. Medicare reviews it and sends a decision letter. If Medicare still says no, you can request a second level of appeal called a reconsideration, which takes longer but may succeed if your doctor provides new information.

Switching brands or getting strips without a prescription

If your current brand of strips is expensive or not covered, ask your doctor if you can switch to a different brand. Medicare covers most major brands — OneTouch, Accu-Chek, Freestyle, Contour — but the approved amount may differ slightly by brand. Your pharmacy can tell you which brands have the lowest out-of-pocket cost under your plan.

Some people buy test strips over the counter without a prescription to avoid the Medicare approval process or to get a brand Medicare does not cover. This is legal, but Medicare will not pay for strips bought this way. If you choose to do this, you pay the full retail price, which is often $1 to $3 per strip depending on the brand.

What to ask your doctor

Before your next appointment, write down how many times per day you currently test your blood sugar. Ask your doctor: "Do you think I should be testing more or less often?" and "Can you write an order for test strips that Medicare will cover?" If your doctor says you do not need strips, ask why — sometimes doctors assume patients will not test regularly, but if you are willing to, your doctor may be willing to prescribe them.

If your prescription was denied, ask your doctor: "Can you resubmit this with a note about why I need this frequency?" or "Can you file a redetermination appeal with Medicare?" Most doctors' offices have staff who handle these appeals regularly and can do this without extra cost to you.

Frequently Asked Questions

Does Medicare Part D cover glucose test strips?

No. Part D covers prescription drugs, and test strips are classified as durable medical equipment, not drugs. Part B is the program that covers them. If you have a Medicare Advantage plan that includes Part D, the strips are still covered under the medical equipment benefit, not the drug benefit.

What if I use a continuous glucose monitor instead of test strips?

Continuous glucose monitors (CGMs) like Freestyle Libre and Dexcom are covered by Medicare Part B if your doctor prescribes them. The coverage rules are similar — your doctor must write an order, and Medicare covers the sensors and transmitters. Some CGMs also require a separate reader device, which may or may not be covered. Ask your doctor and your pharmacy which CGM brands Medicare covers in your area.

Can I get more strips if I test more often than my prescription allows?

You can ask your doctor to increase the quantity on your prescription. Your doctor will need to write a new order with the higher amount, and Medicare will review it. If your doctor documents that you need more frequent testing for a medical reason, Medicare usually approves the increase. This takes a few days to a week.

What happens if I run out of strips before my next refill?

You can ask your pharmacy to refill early if you have a medical reason — for example, if you are adjusting insulin or having low blood sugar episodes. Your pharmacy will contact Medicare to request an early refill. Medicare may approve it or may tell you to wait until your regular refill date. If Medicare says no, you can pay out of pocket for strips to bridge the gap.

Do I need to use a specific brand of meter to use Medicare-covered strips?

No. Test strips are brand-specific — OneTouch strips only work in OneTouch meters, for example — but you can use any brand that Medicare covers. If you already have a meter from a previous purchase, you can use strips for that brand. If you need a new meter, ask your pharmacy or the strip manufacturer whether they offer free or low-cost meters when you order strips.