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Diabetes Supplies and Medication for Medicare Part B

Who is Covered

If you are 65 years and older, are disabled or have end-stage kidney disease, you probably have Medicare Part A and B as your primary health plan.

 Part A covers the cost related to hospital fees, and part B for covers the cost related to medical visits, lab tests and diabetes education and supplies.

 

Medicare will cover most of the medication for blood sugar monitoring: monitor, test strips, lancets or needles, lancing device, control solution and replacement batteries. If you can control you diabetes through a healthy diet with low sugar foods, daily exercise and diabetes pills, you can be qualified for a 100 strips every three months every three months. If you are a type 1 or type two diabetic and take insulin, you can get up to 100 strips monthly. In order to obtain theses supplies you will need a prescription from you doctor or health care provider that indicates the following:

·        That you are diabetic

·        The type of meter you need

·        The type of diabetes you have type 1, 2 or gestational diabetes

·        The number of strips and lancets you need per month

·        How often you will need to monitor your blood sugar level

 

As of 2003, Medicare no longer allows people to file their own claims for diabetes supplies. The drug store at which you purchase you supplies, such as CVS, Walgreen, Rite Aid, etc, must file the claim. Medicare no longer permit you to file your claim for diabetes supplies directly. The new policy is that your diabetes supplies provider should file the claim (as CVS, Walgreen, Rite Aid) for all brands of blood sugar meters and supplies.

 

If you have Medicare Part B, Your drug store pharmacist will assist you to file the claim. You will need your Medicare card that proves that you have part B coverage and a diabetes prescription from your health care provider or doctor. On the average you can live your diabetes supplies provider with one to three months of diabetes supplies. You are, however, required to pay on the average of 20 percent co-insurance.

 

Therapeutic and Orthopedic Shoes

The shoes that are cover by Medicare are depth-inlay shoes, custom-molded shoes and shoe inserts. These shoes are for people with diabetes who have feet problem and complications.  For Medicare to cover the cost of these shoes your doctor must certify that you have diabetes and have one or more of the following conditions:

 

·        Foot ulcers

·        Calluses that could lead to ulcers

·        Neuropathy or nerve damage in legs and feet

·        Poor blood circulation

·        Deformity of the foot or leg

 

Medicare covers 80 percent of the Medicare-approved cost of the shoes and you or your co-insurance pays the remaining 20 percent. Please verify that the provider who makes or sells the shoe accept Medicare.

 

Cover Preventative Tests and Treatments

Medicare Part B cover the following:

Glaucoma screening

Patients are allowed to have one within a 12 months period. The screening has to be conducted by an eye optometrist or ophthalmologist.

Cost

Patients pay 20 percents of the Medicare-approved amount after paying your annual Part B deductible.

 

Flu Shot

Diabetes patients are allowed an annual flu shot in the fall or winter

 

Diabetes screening

If you think that you may be at risk of diabetes, seek advice from a doctor. Part B preventative health care benefit covers people who are at risk of becoming diabetic. The goal is to detect diabetes earlier and to help an increasing number of people to get early preventative care. The screening involves a simple blood test to measure your blood sugar. It is very important to note that the screening should occur within the first six months after you have become eligible for Medicare. Failing this, it will be no longer available to you.

 

Pneumococcal Pneumonia Shot

Persons over the age of 65 only need one Pneumococcal pneumonia shot after the age of 65. If you received the shot when you were 64 or younger, you may need one more shot after the age of 65. If your doctor accepts Medicare there is absolutely no charge for the shot.

 

Diabetes Education

The only diabetes education programs that are covered by Medicare is those that are recognized by the American Diabetes Association. To learn more about the over 3000 programs that are available, please call the American Diabetes Association 800-DIABETES (342-2383).

 

Medicare will cover 10 hours of diabetes self-management training for the first year that you are diagnosed with diabetes or the first year of your Medicare coverage. The training is mainly provided in groups. Medicare provides 2 additional hours of training each year after the first year of training.

 

Medical nutrition Therapy

Nutrition counseling is covered for diabetes in the event your health care provider suggest it and if counseling is done by a registered dietitian. In the first year of coverage, you are given at list three hours of nutrition counseling. Each year follow, you are given up to 2 hours of counseling. Medicare covers 80 percent of the approved amount for diabetes self-management training and nutrition counseling after you have fulfilled your yearly Part B deductible of $100. You are responsible for the remaining 20 percent.

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