- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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Sept. 30, 2011
Diabetes supplies: What does Medicare cover?
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
This blog is the first in a three-part series in which we discuss Medicare coverage for diabetes supplies.
Medicare is the U.S. health insurance for people age 65 and older and also for some younger individuals with certain disabilities. Medicare is made up of four parts:
- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part C (medicare advantage plans)
- Medicare Part D (prescription drug coverage)
Diabetes supplies and education are covered under Medicare Part B.
Blood glucose self-testing supplies include blood glucose meters, blood glucose test strips, lancet devices, lancets and glucose control solution.
- If you have diabetes and take insulin, Medicare covers 100 test strips and lancets every month.
- If you have diabetes but don't take insulin, Medicare covers 100 test strips and lancets every three months.
However, if your doctor says it's "medically necessary," Medicare will cover additional test strips and lancets. For questions about diabetes supplies, contact Medicare at 800-MEDICARE (800-633-4227).
Tips for ensuring coverage:
- Order your supplies from a pharmacy or medical equipment supplier who's enrolled in Medicare and accepts assignment.
- Have a prescription from your doctor for your lancets and test strips every 12 months; ask your health care provider for refills of your supplies.
- If you can't find a supplier or pharmacy in your area who's enrolled in Medicare and accepts assignment, try a mail order supplier who does. This could even save you money.
Medicare also covers things like insulin pumps, insulin, and therapeutic shoes or inserts if you meet certain conditions. In the next couple blogs, I will try to address Medicare's coverage specifications for therapeutic shoes and insulin pumps.
Note that many states have insurance plans that also cover specific diabetes supplies. And, if you're eligible, Medicaid covers diabetes supplies.
Have a good week.
Regards,
Nancy
15 comments posted
June 10, 2013 5:25 p.m.
My sister uses the insulin pen.Does Medicare part B,pay for it? She is paying alot of money for the pen.I told her, I think Medicare will pay for it.
- Marlene
February 5, 2013 8:48 a.m.
Thank you. This was very quick, precise and very helpful. Thank you again.
- Nancy
September 26, 2012 3:04 p.m.
Maintaining a blood glucose log is always a good idea, but proof is only required when using more test strips than Medicare allows. Medicare allows up to 100 test strips per month.
- Nancy and Peggy
September 20, 2012 7:20 p.m.
Today I received mandate from the pharmacy to supply them with a log to document the use of test strips paid for by Medicare. Is this a new requirement by the government? Thank you for any helpful information.
- Don
July 23, 2012 7:06 p.m.
I was not aware that diabetic supplies were covered by Part B Medicare. I have been paying a big co-pay because I do not have part D. Did i misunderstand this blog?Even tho' I would still have to pay for my insulin it would be a help if I could get a break on my strips and lancets
- Sandy
June 4, 2012 10:23 a.m.
Sharon: The insulin companies have patient fincancial assistance programs. Contact the insulin company for further information. You can also check their website for more information. You didn't mention what insulin you are on but NPH store brand can be as low as around $25 per vial the last we checked in early 2012(check with your local department stores).Ask your provider if that type of insulin is an alternative for you.
- Nancy and Peggy
May 31, 2012 6:35 p.m.
iam about to enter the dreaded donut hole with medicare part D and will not be able to buy my insulin. my doctor says i cannot go back to taking oral meds so does anyone know what my next options might be?
- sharon
May 13, 2012 12:30 a.m.
Ever since they came out with the insulin pen it has made life sooo much easier to inject insulin. I use the BD Nano needle with the pen and it is so tiny you don't feel anything. I hate needles but these guys work great. I also love the fact you don't need to keep the pens cool. It's so easy to inject why flying or traveling aboard now. And Medicare paids for them. So if you are tired using needles have your doctor put you on the pen...
- Joe
January 19, 2012 1:36 p.m.
I enjoy you columns & find them to be very helpful and informative. Keep it up! We need all the tips we can get. I'm still looking for that long-lost recipe for the great spice cabbage soup. It's based on V-8 & is fabulous...lost the recipe though. Help! Thanks!
- Linda
October 12, 2011 10:53 p.m.
Medicare covers insulin pump supplies (not sure about the pump itself) if you meet certain criteria, even if you're Type 2. Your fasting C-peptide must be quite low (I believe it must be below 0.8) and you need to have a fasting bg done at the same time that is below 225.
- Ruth
October 10, 2011 10:21 a.m.
My 21 year old son was diagnosed with Type 1 Diabetes right before he turned 13 years old. He does not have his own medical insurance, but is currently covered under his dad's insurance, which has an extremely high deductible. My son is working 30 hours a week at minimum wage. He will not be able to afford his medicine when he moves out on his own. Could he be eligible for Medicare or Medicaid?
- Cindi
October 6, 2011 10:32 p.m.
I have a friend that is type 2 but cant control her high blood sugar. Her doctor says that she would benefit from an insulin pump. She says Medicare won't pay for an insulin pump. She says she can't afford I do not think she is getting the right information.
- marjorie
October 4, 2011 1:17 p.m.
Medicare also covers prescribed insulin that is used in a pump. I hope they will someday cover the continuous glucose monitor and glucose sensors.
- Florian
October 4, 2011 Noon
This is a very useful post! Thank you. I am looking forward to the next one about coverage of insulin pumps and related supplies, like Continuous Glucose Monitors--both of which I use.
- Janis
October 2, 2011 9:08 a.m.
Can you devote some space to how medicare reimbursement meshes with private prescription and health insurance when medicare is either the primary or secondary insurance?
- jim
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