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Reducing Medicare Coverage Confusion

Reducing Medicare Coverage Confusion

A primer on Medicare coverage and diabetes supplies

Many people with diabetes aren’t sure which Medicare card to use for meters, test strips and other supplies. Understanding your test strip coverage—and how to access the benefits you’re entitled to—could really save you money.

Determining Medicare coverage

In the United States, most insurance companies, and Medicare Part B, provide some coverage for diabetes supplies, including blood glucose meters and test strips.

Whether you have private health insurance through your employer, or participate in a government program (Medicare/Medicaid) that provides health care insurance coverage and reimbursement, coverage varies by provider. Contact your insurance carrier for a complete coverage list.

Medicare, the nation's largest health insurance program, is for:

  • People age 65 or older
  • People under age 65 with certain disabilities
  • People of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)

It pays to know your coverage. For example, all blood glucose testing supplies are covered by Medicare Part B.

To verify your Medicare coverage and eligibility:

  • Present your red, white & blue Medicare card (see image) to your pharmacist
  • Review your Medicare Summary Notice
  • Call 800 Medicare or visit www.Medicare.gov

Getting reimbursed

Whenever you purchase diabetes supplies, simply present your red, white & blue Medicare card to your pharmacist, and your test strips will be covered under Medicare Part B.Whenever you purchase diabetes supplies, simply present your red, white & blue Medicare card to your pharmacist, and your test strips will be covered under Medicare Part B*.

Use your red, white & blue card to cover:

  • Test strips
  • Blood glucose meters
  • Insulin pumps
  • Other diabetic supplies
  • Doctors visits

Other things your should know about Medicare

  • Diabetes education and nutrition classes may be covered. If you have private insurance, your insurance company may pay all or part of the cost of your diabetes education (self-management) programs. Contact your insurance company to find out which diabetes benefits they offer. Medicare/Medicare Part B and Medicaid programs also cover the cost of certain diabetes education classes and Medicare includes medical nutritional therapy provided by a dietitian with the diabetes benefit. The American Dietetic Association and American Association of Diabetes Educators has more information on this benefit. Please be aware that the Medicare, Medicaid and diabetes education programs are not automatically available to all U.S. citizens and residents—you need to meet certain eligibility criteria in order to receive these benefits. For Medicare Part B beneficiaries, you must have a prescription from your doctor and meet all other terms and conditions of the Medicare program for coverage.
  • Consider taking Medicare Part B when you are first eligible. Otherwise, the cost of Part B will go up 10 percent for each full 12-month period that you could have had Part B but didn’t sign up for it, except in special cases.

Medicare FAQs

Q. Are my test strips still covered by Medicare Part B?
A. With a prescription, diabetes test strips and meters are covered by Medicare Part B, just as they always have been. Remember: present your red, white & blue Medicare card to your pharmacist when you fill your prescription.

Q: Do my test strip purchases count toward the Part D “donut hole?”
A: No, test strips and meters are covered by Medicare Part B, not Part D; therefore, they do not count toward the Part D “donut hole.”

Q. If I have a Medicare Advantage managed plan, am I still eligible for coverage under the red, white & blue Medicare card?
A. Medicare Advantage plans have their own set of requirements regarding test strips and meters. If you are covered by a Medicare Advantage plan, you should check with your plan for details.

Q. I am covered under both Medicare and Medicaid. Does this affect my coverage for test strips?
A. In most cases, you are covered under Medicare Part B for diabetes test strips and other diabetes testing supplies. Terms and conditions may vary by state, check with your plan for details.

Q. How can I verify my Medicare coverage information?
A. Call 800 MEDICARE or visit www.Medicare.gov.

For more information you can also visit www.TestStripCoverage.com or call the OneTouch® Customer Service Hotline at 866 231-0672.

*Most people pay a monthly premium for Part B

 

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