Does Medicare Cover Diabetic Test Strips? 

If you’re a senior with diabetes, you know how important it is to monitor your blood glucose levels throughout the day. Although continuous glucose monitoring devices may be convenient, they aren’t for everyone. Many seniors opt to use traditional test strips instead. Test strips are discreet and can be transported easily, and they are available from a variety of pharmacies and websites. Will your Medicare benefits cover the cost of diabetic test strips?

Medicare benefits available under Original Medicare are designed to help pay for healthcare costs related to medical necessities. Because America has such a large population of diabetics, many of whom are seniors, the Centers for Medicare & Medicaid Services (CMS) has designed specific rules and regulations related to Medicare coverage for diabetes care.

Medicare Part B coverage for diabetic test strips

Medicare coverage is available for traditional diabetic test strips through Part B (medical insurance). This is the part of Medicare that covers outpatient care and supplies, including doctor visits and durable medical equipment (DME).

Medicare Part B supplies coverage for up to 300 test strips every three months for Medicare recipients who take insulin as part of their diabetes care. If you do not require the use of injectable insulin, Medicare benefits for test strips are limited to 100 test strips every three months.

CMS states that additional testing supplies are available for Medicare recipients who require them. To get authorization for a greater number of test strips, you will need to work with your doctor to document the medical necessity of additional test strips. CMS also states that you may need to document your own testing schedule to show that the number of strips traditionally provided is insufficient for your needs.

Medicare Part A coverage for diabetic test strips

Inpatient care costs are covered by Medicare insurance under Original Medicare Part A. This part of Medicare covers hospital stays and admittance to skilled nursing facilities.

While admitted to a Medicare-participating inpatient facility, all care, including any diabetic test strips supplied as part of your care, is covered by Medicare for 60 days in a hospital. If you are admitted to a skilled nursing facility, your care is covered for 20 days.

How much do diabetic test strips cost?

As mentioned above, diabetic testing supplies are available from a number of sources across the country and online. In order to be eligible for Medicare coverage, your strips must be purchased from an approved Medicare supplier.

This means that if you purchase test strips from a store or other source that is not on Medicare’s list of approved suppliers, you will be responsible for the full cost of your supplies. As a result, it’s important to check with any suppliers, including your local pharmacy, to ensure they are enrolled in Medicare before making a purchase.

Do Medicare Advantage plans cover diabetes test strips?

Medicare Advantage plans must, at minimum, offer the same coverage as Original Medicare, but they are able to provide additional benefits. This means that Medicare Advantage plans also cover diabetes test strips, but you may also have access to additional discounts on diabetes testing supplies. To learn more, you will need to speak with your plan provider directly or work with an independent Medicare Advantage plan broker to see what options are available in your state.

Does Medicare cover insulin?

If you take insulin as a part of your diabetes care, Medicare also supplies benefits for insulin prescriptions through Medicare Part D. This part of Medicare is optional coverage that you will need to add during your Initial Enrollment Period. You can enroll after your initial enrollment period has ended, but you may be subject to late enrollment penalties unless you had other creditable coverage.

Medicare may cover other prescription medications to treat diabetes through Medicare Part D. You will want to take a look over your plan’s formulary if you are prescribed a new medication to make sure it’s covered. If not, you may ask CMS to make an exception by filing a waiver application.

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