Medicare Benefits for People with Type 1 + Type 2 Diabetes
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Medicare enrollment for 2023 is around the corner—October 15 to December 7, 2022. Whether you’re a person with type 1 or type 2 diabetes, enrolling in Medicare is an opportunity to cover critical medications, supplies, technology, appointments and ongoing healthcare.
Seniors aged 65 or older—and some younger people with diabetes—are eligible for Medicare. Deciding if it’s right for you requires a bit of research to ensure it covers your healthcare needs.
Medicare coverage consists of four parts: A, B, C and D. Only parts A, B and D are relevant for people with diabetes. While Parts B and D have benefits for people with type 1 or type 2 diabetes, Part A has benefits for those with type 1 diabetes.
This guide explains the benefits of Medicare to help you make an informed decision if you’re considering enrolling.
MEDICARE PART A BENEFITS FOR TYPE 1 DIABETES
Medicare Part A covers inpatient care in a hospital, skilled nursing facility care, nursing home care, hospice care and home health care. According to Medicare coverage guidelines for type 1 diabetes, people with type 1 diabetes are eligible for hospital treatment if admitted as inpatients.
Medicare also covers the cost of skilled nursing care for approved facilities and temporary enrollment. This means people with type 1 diabetes don’t qualify for this benefit if enrolled long-term.
MEDICARE PARTS B AND D BENEFITS FOR TYPE 1 AND TYPE 2 DIABETES
Medicare Part B covers two types of services: medically necessary and preventive. This includes supplies and services necessary for diagnosing or treating medical conditions. On the other hand, Part D covers prescription and generic drugs.
MEDICARE PARTS B BENEFITS FOR PEOPLE WITH TYPE 1 AND TYPE 2 DIABETES
Medicare Part B covers diabetes supplies, screenings and related services. Here are the details:
1. BLOOD SUGAR SELF-TESTING EQUIPMENT AND SUPPLIES
The benefits include at-home blood sugar testing supplies like glucose monitors, lancet devices and lancets, and continuous glucose monitors. This plan covers all people with diabetes, whether you use insulin or not. But supply amounts can vary depending on your diabetes management regimen.
- If you use insulin: you may be eligible for up to 300 test strips and 300 lancets every three months.
- If you don’t use insulin: you may only qualify for up to 100 test strips and 100 lancets every 3 months.
A doctor’s prescription is necessary to utilize this benefit. You can order and pick up the supplies at a pharmacy or a medical equipment supplier in Medicare’s network.
2. INSULIN DELIVERY TECHNOLOGY
Part B may also cover insulin pumps, insulin patches and insulin pod technology. Coverage for an insulin pump requires a doctor’s prescription.
3. THERAPEUTIC SHOES OR INSERTS
Medicare Part B may also cover therapeutic shoes, which might be for some people with diabetes and neuropathy. Your doctor must provide documentation that you require specialized shoes or inserts. Specific shoes and inserts include:
- A pair of depth-inlay shoes and three pairs of inserts
- One pair of custom-molded shoes with inserts and two additional pairs of inserts for people who can’t wear depth-inlay shoes.
4. DIABETES SCREENING TESTS
Part B covers screening test costs for people at risk of diabetes. Screening tests go a long way in helping detect diabetes early. The cost covers up to two diabetes screening tests in a year.
5. MEDICARE DIABETES PREVENTION PROGRAM
This is a two-year program for people with prediabetes aiming to prevent or delay the progression to type 2 diabetes. The primary training occurs in a group setting within the first six months. The next six months are for follow-ups to promote healthy lifestyle habits. The last 12 months are maintenance sessions to help you sustain your progress long-term.
6. DIABETES SELF-MANAGEMENT TRAINING
Diabetes self-management training helps people with diabetes learn how to manage the daily demands of diabetes. You need a prescription from your doctor or other health care provider to receive this training.
7. MEDICAL NUTRITION THERAPY SERVICES
Part B covers medical nutrition therapy services for people with diabetes or renal disease. A doctor’s prescription is required for these services.
8. HEMOGLOBIN A1C TESTS
A hemoglobin A1c test can give you a general idea of what your average blood sugar level has been over the previous three months. Your healthcare team will set up A1c testing for you within a local laboratory or may offer in-office A1c testing.
MEDICARE PARTS D BENEFITS PEOPLE WITH Diabetes
Medicare Part D covers diabetes medications and supplies like:
- Insulin (injectable or inhalable)
- Oral or injectable medications like: metformin, Invokana, Ozempic, etc.
- Syringes, insulin pens, lancets, alcohol swabs, gauze, etc.
Learn more about Medicare enrollment.