Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. covers diabetes test strips.
After you meet your deductibleA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself., you’ll pay 20% of the cost.
You can get your diabetes test strips in the mail or via a pharmacy.
You can usually get 300 test strips per month if you use insulin, or 100 if you do not.
Medicare covers diabetes test strips under Medicare Part B. Diabetes test strips are durable medical equipment (DME), which means you must purchase test strips from a Medicare-approved supplier. However, Medicare may limit the number of test strips you can get every month.
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Medicare covers a portion of the diabetes test strips costs under Medicare Part B. After you have met your Part B deductible, you will pay 20% of the Medicare-approved amount for diabetes test strips.
For Medicare to cover your diabetes test strips, your doctor must prescribe the test strips. The prescription should include the following information:
- Confirmation that a doctor has diagnosed you 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
- The number of test strips and lancets you need
You will then take this prescription to your diabetes testing supply vendor of choice. If they accept Medicare assignment, Medicare will reimburse them for providing your test strips and other supplies.
Glucose test strips are small, thin strips that will transmit blood obtained from a fingerstick to a blood glucose monitor. You will usually use one test strip each time you test your blood sugar levels. However, you may have to use more than one test strip if your machine does not read the strip accurately.
Glucose test strips must be compatible with the blood glucose monitor a doctor prescribes. A doctor may consider different machine types, ease of use, and costs when evaluating potential types. Once you select a blood glucose monitor, you will order the test strips that work with that monitor.
You and your doctor will determine the blood glucose monitor brand that fits your needs. For example, some people may want a large, easy-to-read display screen. Others may want a blood glucose monitor that requires the least amount of blood possible to measure a person’s blood glucose levels. Cost may also be a factor in choosing not just a blood glucose monitor, but the test strips, too. Many commonly come in 50 to 100 test strips per container.
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You may receive diabetes testing supplies in two ways. You can get them through a local pharmacy or supplier (but they must accept Medicare), or you can order your supplies to arrive by mail. To find a Medicare supplier, you can visit Medicare.gov/supplier or call 1-800-MEDICARE (1-800-633-4227).
Medicare has a National Mail-Order Program for diabetes testing supplies. Under this program, you can choose a national supplier who works with Medicare to provide diabetes supplies. These suppliers cannot charge you more than the cost of your unmet deductible plus 20% of the supplies’ costs through Medicare.
Mail-order suppliers who accept Medicare must meet the following standards:
- They must provide the brand your doctor prescribes.
- They cannot try to influence your choice of test strips brand.
- They must make the same products available to those with Medicare as those without it.
Before choosing any supplier to receive your supplies, including test strips, you must ask them if they are enrolled in Medicare and accept assignment. If the supplier is not enrolled, Medicare will not pay its portion, and you will be responsible for paying for the test strips. By accepting assignment, Medicare will pay the supplier directly so you don’t have to pay for the test strips and wait for reimbursement.
You need a new prescription for your diabetes testing supplies at least every 12 months to make sure Medicare will still pay its portion.
Medicare will pay for up to 300 test strips and 300 lancets every month when you use insulin to manage your diabetes. If you don’t use insulin to control your diabetes, you may still be able to qualify for 100 test strips per month.
If you test your blood sugar more frequently, you may be able to get more test strips. Your doctor will have to write a prescription stating that receiving more test strips is medically necessary. Your doctor may ask you to keep a log of how often you test your blood sugar levels to further support that you need more than the allotted amount of test strips.
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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 Medicare Advantage, 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.
Under Medicare’s rules for mail-order suppliers, the suppliers must provide the same options for blood glucose monitors to those with Medicare as they do for customers with other insurance types.
Medicare maintains a list of national and local suppliers of diabetes supplies. You can visit Medicare.gov/supplier and input your zip code to find suppliers that serve your area. However, it’s possible that you’ll need to contact multiple companies as every supplier may not have your blood glucose test strips of choice.
If you don’t have access to a pharmacy that accepts assignments from Medicare for diabetes testing supplies, you can order supplies through Medicare’s mail-order program. These enrolled suppliers accept assignment from Medicare, charge you the 20% copayment and accept reimbursement from Medicare directly.
If your test strips become damaged (such as by excess exposure to water), Medicare will typically replace your supplies if the damage was from an emergency or disaster. You should contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) to learn about replacing your damaged supplies.