Orlando Harmon
Diabetes test strips can be costly, and having insurance cover them can be a huge relief. Medicare Part B covers blood sugar test strips as durable medical equipment (DME) for people with diabetes. After paying the annual Part B deductible, you will pay 20% of the price of test strips from appropriate suppliers. You can get your diabetes test strips in the mail or via a pharmacy. To receive coverage, you must obtain blood sugar test strips from a Medicare-approved supplier who accepts the assignment.
| Characteristics | Values |
|---|---|
| Type of insurance | Medicare Part B (Medical Insurance) |
| What does it cover? | Blood glucose (blood sugar) test strips, blood glucose monitors, insulin pumps, syringes, inhaled insulin devices, antidiabetic drugs, lancing devices, and lancets |
| Who is it for? | People with diabetes |
| Requirements | A prescription from a treating physician is required for coverage. The prescription must include confirmation of a diabetes diagnosis, the type of device needed and why, how often blood glucose levels should be tested, and the number of test strips and lancets needed. A new prescription is required every 12 months, and refills must be requested before running out. |
| How much does it cover? | Up to 300 test strips every 3 months for someone who uses insulin and 100 test strips every 3 months for someone who does not use insulin. Additional test strips may be covered if a doctor deems them medically necessary. |
| Cost | After meeting the Part B deductible, the individual pays 20% of the Medicare-approved amount. |
| Supplier | Must be a Medicare-enrolled supplier who accepts the assignment. |
| Replacement | Medicare will typically replace supplies if they are damaged due to an emergency or disaster. |
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What You'll Learn
Medicare Part B covers diabetes test strips
For Medicare to cover your diabetes test strips, your doctor must prescribe the test strips. The prescription should include confirmation that you have been diagnosed with diabetes, the type of glucose monitor or device you need and why you need it, how often you should test your blood glucose levels, and the number of test strips and lancets you need. You will then take this prescription to your diabetes testing supply vendor. If they accept Medicare assignment, Medicare will reimburse them for providing your test strips and other supplies.
Medicare covers a number of common blood glucose monitors and their test strips. Examples include OneTouch and Accu-Chek. If you prefer a particular brand, your doctor can write the prescription saying "Do Not Substitute". If you have a Medicare Advantage plan, your plan may have preferred vendors or dictate what diabetes testing brands are covered. You should contact your insurance company to determine what brands your insurance company covers. This will ensure you’ll be reimbursed for your blood glucose monitor and testing strips.
Medicare will typically replace your supplies if they become damaged due to an emergency or disaster. If your test strips become damaged, for example, by excess exposure to water, contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) to learn about replacing your damaged supplies.
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You must meet certain criteria
To receive coverage for diabetes test strips, you must meet certain criteria. Firstly, you need to have a prescription from your doctor. The prescription should include specific information, such as confirmation of a diabetes diagnosis, the type of glucose monitor or device required, the frequency of blood glucose level testing, and the number of test strips and lancets needed. You will need to obtain a new prescription annually and request refills to ensure you do not run out.
Secondly, you must purchase your test strips from a Medicare-approved supplier who accepts assignments. This means they agree to charge only the coinsurance and Part B deductible for the Medicare-approved amount. If you obtain test strips from a supplier that is not Medicare-approved or does not accept assignments, you may be responsible for the full cost or an additional cost.
Thirdly, Medicare Part B covers a specific number of test strips every three months, depending on your insulin usage. If you use insulin, you can receive up to 300 test strips every three months. If you do not use insulin, you can receive 100 test strips during this period. To obtain additional test strips beyond these quantities, a doctor must deem them medically necessary.
Finally, it is important to note that Medicare Advantage plans may have preferred vendors or dictate what diabetes testing brands are covered. Therefore, you should contact your insurance company to determine which brands are covered to ensure reimbursement for your blood glucose monitor and testing strips.
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Medicare will only cover a certain number of test strips
Medicare Part B covers blood sugar test strips as durable medical equipment (DME). However, it is important to note that Medicare will only cover a certain number of test strips every three months. The number of test strips covered depends on whether you use insulin or not. If you use insulin, you can typically get up to 300 test strips every three months. If you do not use insulin, you can usually receive up to 100 test strips during the same period.
To receive coverage for diabetes test strips, you must obtain a prescription from your treating physician. The prescription must include specific information, such as confirmation of your diabetes diagnosis, the type of glucose monitor or device you require, how frequently you need to test your blood glucose levels, and the number of test strips and lancets you need. You will then take this prescription to a Medicare-enrolled pharmacy or supplier who accepts assignments.
It is worth noting that you may be able to obtain additional test strips if your doctor deems them medically necessary. In such cases, your doctor may ask you to keep a log of how often you test your blood sugar levels to support the need for extra test strips. Once you have met your Part B deductible, you will typically pay 20% of the Medicare-approved amount for the test strips.
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Test strips must be prescribed by a doctor
For Medicare to cover the cost of diabetes test strips, the patient must have a prescription from their doctor. This prescription must include confirmation of a diabetes diagnosis, the type of glucose monitor or device required and why it is required, how often the patient needs to test their blood glucose levels, and the number of test strips and lancets required. The prescription must be renewed annually, and the patient must request refills before they run out.
Medicare Part B covers blood sugar test strips from Medicare-enrolled suppliers. After paying their annual Part B deductible, the patient will pay 20% of the price of test strips from appropriate suppliers. Medicare will cover 300 test strips every 3 months for someone who uses insulin and 100 test strips every 3 months for someone who does not treat their diabetes with insulin. It will only cover additional blood sugar test strips if a doctor declares them medically necessary.
Medicare Part B covers blood glucose (blood sugar) test strips as durable medical equipment (DME). After meeting the Part B deductible, the patient pays 20% of the Medicare-approved amount (if the supplier accepts assignment). Medicare pays for different kinds of DME in different ways. Depending on the type of equipment, the patient may need to rent or buy the equipment. It is important to ask a supplier if they participate in Medicare before purchasing DME. If suppliers are participating in Medicare, they must accept assignment, which means they can charge only the coinsurance and Part B deductible for the Medicare-approved amount. If suppliers are not participating and do not accept assignment, the patient may have to pay the full cost of the DME.
Medicare Advantage plans may have preferred vendors or dictate what diabetes testing brands are covered. It is recommended that patients contact their insurance company to determine what brands are covered to ensure they will be reimbursed for their blood glucose monitor and testing strips. Medicare maintains a list of national and local suppliers of diabetes supplies, which can be found at Medicare.gov/supplier.
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You can get your test strips in the mail or via a pharmacy
You can get your diabetes test strips in the mail or via a pharmacy. Medicare Part B covers blood sugar test strips and some other diabetic supplies such as blood glucose self-testing equipment and supplies, therapeutic shoes and inserts, and insulin pumps and the insulin for the pumps.
Medicare will cover blood sugar test strips from a medical supplier, but you will need a prescription from your doctor to place the order. Medicare also has a mail-order program for diabetic testing supplies. You can enter your zip code to find a supplier on the Medicare website. You can also buy diabetic test strips over the counter at your local pharmacy. Even though a prescription isn’t required for diabetic supplies like glucometers, test strips, and lancets, you may need one for insurance to cover the costs.
There are multiple subscription services available for diabetic test strips. These services can make it easier to prevent running out of test strips and they might cost less than the ones you buy at a typical pharmacy. You don’t need a prescription for diabetic test strips to sign up for any of these subscription services. However, you should check with your insurance company to see if they cover the subscription service.
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Frequently asked questions
Yes, Medicaid covers diabetes test strips under Medicaid Part B.
Medicaid Part B covers blood sugar test strips, blood sugar monitors, and insulin pumps.
You must meet specific criteria for these items to be covered by Medicaid. You will need a prescription from your doctor, which must be renewed annually, and you will need to request refills before you run out. You must also obtain your test strips from a Medicaid-enrolled supplier.
