Medicare Coverage of Diabetes Supplies, Services ...
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
3
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