What Medicare covers for test strips

Medicare Part B covers blood glucose test strips, but the number you get each month depends on how often your doctor says you need to test. Medicare does not set a fixed monthly amount for everyone. Instead, the program covers test strips based on a prescription from your doctor that specifies how many times per day you should test your blood sugar.

If your doctor prescribes testing once daily, Medicare typically covers about 100 strips per month. If your prescription says test twice daily, you would receive roughly 200 strips per month. The actual number can vary slightly depending on your specific situation and which supplier fills your prescription.

You pay 20 percent of the Medicare-approved amount for test strips after you meet your Part B deductible. Some people have supplemental insurance or Medicaid that covers this 20 percent coinsurance, which would reduce or eliminate your out-of-pocket cost.

Key Takeaways

  • Medicare covers test strips based on your doctor's written prescription for how many times per day you should test, not a set monthly number for all patients.
  • A prescription for once-daily testing typically results in about 100 strips per month, while twice-daily testing covers roughly 200 strips.
  • You are responsible for 20 percent coinsurance after meeting your Part B deductible, unless you have supplemental coverage.
  • Your doctor must document medical necessity for the testing frequency you need, and Medicare may request records to verify the prescription is appropriate.

How your doctor's prescription determines your coverage

Your doctor writes a prescription that states how many times per day you should check your blood glucose. This prescription is the foundation of what Medicare will cover. The prescription must show that testing at that frequency is medically necessary for your condition — for example, if you take insulin, your doctor can justify more frequent testing than someone managing diabetes with diet alone.

When you send this prescription to a Medicare-approved supplier, the supplier uses it to determine how many strips to send you each month. If your prescription says test four times daily, the supplier calculates roughly 120 strips per month (30 days × 4 tests). Medicare pays its share based on that prescription.

If you believe your doctor should increase your testing frequency, ask your doctor to write a new prescription with the higher number. You will need to provide the new prescription to your supplier, and they will adjust your monthly shipment accordingly.

What happens if you need more strips than your prescription allows

If you run out of strips before the end of the month, you have a few options. You can contact your doctor and ask them to increase your prescription if they believe more frequent testing is medically necessary. If your doctor agrees, they will write a new prescription, and you can submit it to your supplier for additional strips.

If your doctor will not increase the prescription, you can purchase additional strips out of pocket from a pharmacy or online retailer. Test strips vary widely in price — some cost $0.50 to $1.00 per strip when bought without insurance, while others cost more or less depending on the brand and where you buy them.

Some people find that switching to a different brand of meter and strips — one that Medicare covers at a higher quantity or that costs less out of pocket — helps stretch their budget. Talk to your doctor or pharmacist about brands that work well with your routine.

How to order test strips through Medicare

You must use a Medicare-approved Durable Medical Equipment (DME) supplier to order test strips. These suppliers are companies that Medicare has vetted and contracted with to provide diabetes supplies. You cannot straightforward buy strips at a pharmacy and submit the receipt to Medicare for reimbursement.

To find a Medicare-approved supplier in your area, visit the Medicare Supplier Directory at dmepos.cms.gov or call 1-800-MEDICARE. Search for suppliers that carry test strips and meters. Once you choose a supplier, you will provide them with your doctor's prescription and your Medicare information. The supplier handles the billing to Medicare directly, and you pay your coinsurance amount to the supplier.

Most suppliers ship strips to your home monthly. Some allow you to order online, by phone, or by mail. Ask your supplier about their ordering process and how long delivery takes — most take 5 to 10 business days.

When Medicare may deny or limit your strips

Medicare may reduce the number of strips it covers if it determines your prescription is not medically necessary. This sometimes happens if your doctor prescribes very frequent testing but your medical records do not support that level of monitoring. For example, if you test eight times daily but your doctor's notes show you have stable, well-controlled diabetes, Medicare might question whether that frequency is needed.

If Medicare denies coverage or limits your strips, your supplier will notify you. You have the right to appeal. You can ask your doctor to provide additional documentation explaining why the testing frequency is medically necessary, and you can submit that with your appeal. Many appeals succeed when the doctor's records clearly show the medical reason for frequent testing.

You also may face limits if you switch suppliers frequently or if a supplier submits claims that appear excessive. Medicare tracks these patterns to prevent fraud and waste. If you need to change suppliers, inform your new supplier of your current prescription so they can continue your service without interruption.

Test strips and your Part B deductible

Test strips are covered under Medicare Part B, which means they count toward your annual Part B deductible. In 2024, the Part B deductible is $240 (this amount changes each year). You must pay the full cost of test strips until you meet this deductible, after which Medicare pays 80 percent and you pay 20 percent coinsurance.

If you have already met your deductible earlier in the year through other Part B services — such as doctor visits or other supplies — then test strips are covered at the 80/20 split right away. If you have not met the deductible, you will pay the full Medicare-approved amount for strips until you reach $240 in out-of-pocket spending.

Some people with limited income may be covered by both Medicare and Medicaid. Medicaid can pay your Part B deductible and coinsurance, which would reduce your cost to zero. Contact your state Medicaid office to learn whether you meet income and asset limits for this program.

Continuous glucose monitors and test strips

If you use a continuous glucose monitor (CGM) such as a Dexcom or FreeStyle Libre, you may need fewer fingerstick test strips. Some CGMs require fewer or no fingerstick tests because the monitor itself provides glucose readings throughout the day. However, your doctor may still prescribe some test strips for backup or calibration purposes.

Medicare covers certain CGMs under Part B, but coverage rules and the number of sensors provided per month vary. If you use both a CGM and fingerstick strips, your doctor's prescription should reflect the total testing plan — including how many times you will use a fingerstick meter. Your supplier can help coordinate both the CGM supplies and test strips in one order.

Frequently Asked Questions

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

No, Medicare will only cover the number of strips specified in your doctor's prescription. If you test more frequently than prescribed, you will need to purchase the extra strips out of pocket. Talk to your doctor about whether your testing frequency should be increased based on your health needs.

What if my supplier runs out of my brand of test strips?

Contact your supplier and ask about alternatives. Medicare covers most major brands of test strips, so your supplier can usually switch you to a different brand that is in stock. Your meter may need to use the same type of strip, so check compatibility before switching brands.

Do I have to use the same supplier every month?

No, you can change suppliers at any time. However, switching suppliers can cause delays in your shipment, so plan ahead. When you switch, provide your new supplier with a copy of your current prescription so they can resume your monthly deliveries without interruption.

Does Medicare cover test strips if I do not have diabetes?

Medicare covers test strips only for people with a diagnosis of diabetes. If you have prediabetes or are monitoring blood sugar for another reason, Medicare will not cover the strips, and you will need to purchase them out of pocket.

What is the cost of test strips if I do not have Medicare?

Test strip prices vary widely depending on the brand and where you buy them. Without insurance, a box of 50 strips typically costs $25 to $75. Some manufacturers offer patient information programs or coupons that reduce the cost. Walmart and other retailers also sell store-brand strips at lower prices than name brands.