Does Medicare Pay For Diabetic Supplies?
Medicare does not pay for diabetes supplies, but it does cover some types of diabetes supplies as part of the cost of other Medicare covered services. For example, most diabetes supplies are covered when they are used with a procedure that is covered by Medicare, such as a foot ulcer that is associated with a hospital stay.
What are supplies?
Diabetes supplies are items such as syringes, lancets, alcohol swabs and urine testing strips that are used during diabetes treatment.
What is a durable medical equipment supplier (DME)?
A DME is a supplier that is approved by Medicare to supply diabetes supplies and other durable medical equipment. To qualify for Medicare coverage, equipment must be prescribed by a doctor and be medically necessary and expected to last for at least one year. The medical necessity of supplies, such as syringes, is determined based on the frequency and amount of the supplies that are needed.
Will Medicare cover my supplies?
Medicare may cover a portion of your supplies if you are receiving Medicare benefits for a Medicare covered service. The amount that Medicare will cover is based on the amount specified by Medicare as part of the cost of the covered service. For example, Medicare will only pay for diabetes supplies that are part of the cost of a covered hospital stay. Some health plans also cover diabetes supplies.
Does Medicare require a doctor's prescription for supplies?
Yes, Medicare requires a doctor's prescription for diabetes supplies.
Do I need to have my doctor write a prescription each month for my diabetes supplies?
No, a prescription is only required for the first supply of diabetes supplies. After that, you may get your supplies from any supplier that is approved by Medicare. Your doctor will need to write a prescription to qualify for Medicare coverage of supplies.
Can Medicare deny coverage for supplies based on my doctor's prescription?
Medicare can deny coverage for supplies if you do not show a prescription to the doctor or supplier. If Medicare denies coverage for the supplies, you may contact your doctor or supplier and request a written explanation of why they denied coverage. You can then submit this information to Medicare to appeal the denial.
How do I find a DME that is covered by Medicare?
You can use the Medicare website to find a DME in your area.
Can Medicare pay for the cost of diabetes supplies that I purchase over-the-counter?
Yes. It is reasonable to use over-the-counter supplies while you are waiting for your doctor to prescribe the medically necessary supplies. You may be reimbursed by Medicare for over-the-counter supplies if you pay for them and have not used a prescription from your doctor.
What is the difference between a Diabetes Care Plan and a Diabetes Self-management Plan?
A Diabetes Care Plan and a Diabetes Self-management Plan may be used with Medicare to support the care of people with diabetes.
What is a Diabetes Self-management Plan?
A Diabetes Self-management Plan is a written plan that describes the treatment or care that an individual with diabetes needs to manage his or her diabetes. The plan should include information on the diabetes supplies that are needed. It should also include a list of the actions that should be taken in the event of a diabetes emergency.
What is a Diabetes Care Plan?
A Diabetes Care Plan is a written plan that describes the diabetes supplies that an individual with diabetes needs to manage his or her diabetes. The plan should include information on the diabetes supplies that are needed. It should also include a list of the actions that should be taken in the event of a diabetes emergency.
What is an insulin pump?
An insulin pump is a device that delivers insulin through a cannula, a small tube that is inserted into the skin. An insulin pump is used to deliver insulin at specific times throughout the day. An insulin pump is used in addition to daily insulin shots.
What is a blood glucose meter?
A blood glucose meter is a small device that measures the amount of glucose in your blood.
What is a lancet?
A lancet is a device that is used to pierce the skin. It is used to get a drop of blood that is used to test for glucose.
What is a glucometer?
A glucometer is a medical device that measures the amount of glucose in the blood.
What is a urine testing strip?
A urine testing strip is a device used to test for glucose in urine.
What is a syringe?
A syringe is a device used to inject insulin. It is also called an insulin syringe.