Medicare coverage of diabetes supplies, services, and ...

Medicare

Coverage of

Diabetes Supplies,

Services, &

Prevention

Programs

This official government

booklet has important

information about:

? What Medicare covers

? Ways to stay healthy

? Where to get information



Table of contents

Introduction ????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1

Medicare Coverage for Diabetes At-a-Glance ???????????????????????????????????????????????? 3

Medicare Coverage for Diabetes Supplies ?????????????????????????????????????????????????????? 7

Blood sugar self-testing equipment & supplies????????????????????????????????????????????????????? 8

Insulin pumps ????????????????????????????????????????????????????????????????????????????????????????????????????????????? 10

Therapeutic shoes or inserts ?????????????????????????????????????????????????????????????????????????????????????11

Replacing lost or damaged durable medical equipment or supplies in a

disaster or emergency ??????????????????????????????????????????????????????????????????????????????????????????????12

Medicare Coverage for Diabetes Drugs ???????????????????????????????????????????????????????????13

Insulin ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????14

Anti-diabetic drugs ??????????????????????????????????????????????????????????????????????????????????????????????????14

Diabetes supplies ??????????????????????????????????????????????????????????????????????????????????????????????????????14

Medicare Coverage for Diabetes Screenings & Services ???????????????????????????15

Diabetes screenings ??????????????????????????????????????????????????????????????????????????????????????????????????16

Medicare Diabetes Prevention Program ????????????????????????????????????????????????????????????????16

Diabetes self-management training ?????????????????????????????????????????????????????????????????????? 17

Medical nutrition therapy services ??????????????????????????????????????????????????????????????????????????19

Foot exams & treatment ??????????????????????????????????????????????????????????????????????????????????????????19

Hemoglobin A1C tests ??????????????????????????????????????????????????????????????????????????????????????????????19

Glaucoma screenings ???????????????????????????????????????????????????????????????????????????????????????????????20

Flu & pneumococcal shots ?????????????????????????????????????????????????????????????????????????????????????20

¡°Welcome to Medicare¡± preventive visit ?????????????????????????????????????????????????????????????20

Yearly ¡°Wellness¡± visit ?????????????????????????????????????????????????????????????????????????????????????????????20

Supplies & services that Medicare doesn¡¯t cover ?????????????????????????????????????????????20

Helpful Tips & Resources ???????????????????????????????????????????????????????????????????????????????????????21

Phone numbers & websites ????????????????????????????????????????????????????????????????????????????????????? 22

Definitions ???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 23

Section 1: Introduction

Section 1:

Introduction

This booklet explains Medicare coverage of diabetes supplies and services in Original

Medicare and Medicare drug coverage (Part D).

Medicare is the federal health insurance program for people 65 or older, certain people

under 65 who have disabilities, and people with End-Stage Renal Disease (permanent

kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance).

You can join a separate Medicare drug plan to get Medicare drug coverage (Part D).

Medicare covers most¡ªbut not all¡ªof the costs for approved health care services and

supplies.

Medicare Advantage (also known as Part C) is a Medicare-approved plan from a private

company that offers an alternative to Original Medicare for your health and drug

coverage. These ¡°bundled¡± plans include Part A, Part B, and usually Medicare drug

coverage (Part D). If you¡¯re in a Medicare Advantage Plan, contact your plan to find out

more about coverage of diabetes supplies and services.

Note: Go to page 23 for definitions of blue words

1

2

Section 1: Introduction

Section 2: Medicare Coverage for Diabetes At-a-Glance

Section 2:

Medicare Coverage for

Diabetes At-a-Glance

The chart on the next 3 pages provides an overview of some of the diabetes services

and supplies covered by Medicare Part B (Medical Insurance) and Medicare drug

coverage (Part D).

Note: Go to page 23 for definitions of blue words

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