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Medicare and Diabetes

When it comes to Medicare and diabetes, Part B and Part D are most important. Medicare Part B covers services for people who have diabetes. It also covers some preventative services for those who are at risk for diabetes. Medicare Part D (Prescription Drug plan) helps cover supplies for insulin. In order to receive Part B services and supplies, you must be covered under Part B. This also goes for Medicare Part D; you must be covered in order to receive supplies.

What is Diabetes?

Diabetes is a disease when your body causes your glucose (sugar) levels to rise higher than normal. There are two types of diabetes: Type 1 and Type 2. Type 1 is usually diagnosed in child and young adults while Type 2 is the most common form of diabetes. When you have Type 2 diabetes, your body has a hard time using insulin properly. After a while, your pancreas can no longer keep up with making enough insulin to keep your glucose levels normal.

What Does Medicare Cover?

  • Part D covers drugs for maintaining blood sugar (glucose)
  • Part B covers diabetes screenings (eligible for up to two a year)
  • Part B covers diabetes self-management training (DSMT) services for people who have just been diagnosed with diabetes or are at risk for diabetes
  • Part B covers home blood sugar (glucose) monitors as well as the supplies used with equipment (blood sugar test strips, lancet devices, lancets)
  • Part D covers supplies to administer insulin (needles, syringes, gauze etc.)
  • Flu shot and Pneumococcal shot
  • Every six months Part B covers a foot exam for those with diabetic peripheral neuropathy
  • Part B covers a glaucoma test once a year for people at high risk (people at high risk are those with diabetes/have family history of glaucoma)
  • Part D covers insulin that is not administered with a pump
  • Part B covers external durable insulin pumps
  • Part B may cover medical nutrition therapy (MNT) if you have diabetes or kidney disease
  • Part B covers therapeutic shoes or inserts for people who have severe diabetic foot disease
  • Part B covers a one-time review of your health to help educate/counsel you on preventative screenings, shots, referrals and more
  • After 12 months of having Part B, you are able to do yearly “Wellness” visits

How Do You Lower Your Risk of Diabetes?

  1. Healthy Eating: Eat fresh fruits, vegetables, lean meats, poultry and fish (stay away from processed foods)
  2. Physical Activity: Try Biking, swimming, walking, running, dancing, weight-lifting, yoga etc.
  3. Maintain a Healthy Weight: Being overweight raises your risk for Type 2 diabetes, heart disease and stroke – losing just 10-15 pounds can make a huge difference
  4. Quit Smoking: Quit as soon as possible! Absolutely horrible for your health. Smoking raises your bad cholesterol, blood pressure, and puts you at risk of a stroke or heart attack
  5. Maintain a Healthy Blood Pressure: Eat less sodium, maintain a healthy weight, do not smoke, limit alcohol consumption, talk with your health care provider to find a treatment plan etc.

Medicare National Mail-Order Program for Diabetes Testing Supplies

Since 2013, individuals enrolled in Medicare Part B with diabetes have been able to receive mail-order supplies. The mail-order comes with blood glucose test strips, lancets, lancet devices, batteries and more. If you do not want to use the mail-order, you can still pick up your supplies at your local pharmacy.

To learn more about Medicare Part B, click here.
To learn more about Medicare Prescription (Part D) Plans, click here.
To learn more about Type 1 and Type 2 Diabetes, click here.