Diabetic supplies: Medicare Part B coverage and benefits
In the course of managing diabetes, patients can rack up considerable costs in diabetes supplies and services. Older adults eligible for Medicare have a resource for keeping their medical expenses in check: Medicare Part B.
Medicare Part B benefits for diabetes care
Medicare Part B covers both preventative and medically-necessary outpatient care, including many costs associated with managing chronic conditions like type 1 or type 2 diabetes. Medicare Part B coverage extends to diabetes supplies, equipment and clinical care services. Part B coverage can be divided into two main areas: diabetes supplies and diabetes services.
Diabetes supplies and Medicare Part B
Medicare Part B covers essential supplies for monitoring blood sugar levels, as well as some therapeutic gear. Covered supplies include the following:
- Glucose test strips
- Blood glucose meters
- Lancet devices and lancets
- Glucose control solutions
- Therapeutic shoes or inserts for patients with diabetic foot disease
Medicare Part B does not cover insulin unless the patient qualifies for an external insulin pump. In this case, Medicare Part B covers both the insulin and the pump as durable medical equipment. Patients who don't qualify for the pump are responsible for the full cost of insulin and associated supplies, including insulin pens, syringes, needles, alcohol swabs and gauze. However, insulin and insulin-injection supplies may be covered under Medicare Part D.
Medicare: diabetes clinical services
Clinical checkups for diabetics are also included among the Medicare Part B benefits:
- Diabetes self-management training. Medicare Part B may pay for up to ten hours of training, which covers the basics of monitoring blood sugar, diet, exercise and insulin. Some patients may also receive coverage for two hours per year of follow-up training.
- Annual eye exam to screen for diabetic retinopathy.
- Annual glaucoma test.
- Foot exam every six months for patients suffering from diabetic peripheral neuropathy.
- Medical nutrition therapy services, which cover nutritional assessment, one-on-one counseling, and therapy through an interactive telecommunications system.
- Annual flu shot and lifetime pneumococcal shot.
- Physical exam. A one-time "Welcome to Medicare" exam is available within the first year after enrollment in Part B. The exam includes preventative care, screenings and shots. Each year thereafter, patients can receive a yearly Wellness exam.
Generally speaking, the Medicare Part B benefit covers 80 percent of the cost of supplies, equipment or service. The patient is responsible for 20 percent. The Medicare Part B deductible may also apply. Some benefits, such as medical nutrition therapy services, preventative exams and the annual flu shot, are free of charge to the patient at participating Medicare providers.
Cost of Medicare Part B
Medicare Part B is an optional add-on to standard Medicare. Patients pay a monthly premium for the insurance. The amount varies, but the basic premium in 2012 was $99.90 per month. Higher-income patients (incomes $85,000 and above) pay higher premiums, starting at $139.90 per month.
An annual deductible also applies to Medicare benefit claims; in 2012, the Part B deductible is $140.
Diabetes patients looking for more mileage from Medicare can extend their coverage with Medicare Part B. For essential supplies and clinical outpatient visits, Part B helps patients manage the cost of chronic diabetes care.