Medicare Covers Certain Supplies
If You Have Medicare Part B
And Have Diabetes...

Here's What Medicare Will Cover:

If you have diabetes and are on Medicare, you may be eligible to receive home delivery of diabetic supplies to help you control diabetes.

Patients who have Medicare Part B and have diabetes, regardless of whether or not they take insulin, are eligible for Medicare to cover up to 80% of the cost of their diabetic testing supplies.

Medicare covers certain diabetes supplies, including:

• blood glucose monitor
• blood glucose test strips
• lancet devices and lancets
• batteries for your meter
• glucose control solutions for checking the accuracy of test strips and monitors

In order to get Medicare to cover up to 80% of the cost of your diabetic supplies, make sure you order from a Medicare certified supplier. Care 1st is Medicare enrolled and is a participating supplier in the Medicare program so that we will submit all of the Medicare paperwork for you.

Covering the Remaining Costs

You pay 20% of Medicare-approved amounts. However, if you have an existing Medigap policy, you may be able to get some or all of the remaining 20% covered in addition. A Medigap policy is health insurance sold by private insurance companies to fill the "gaps" between what the original Medicare plan covers and what the beneficiary will have to end up paying.

How much of your 20% copay can be covered by your insurance policy depends on the type of secondary insurance that you have purchased. Some plans may cover the Medicare deductible and coinsurance amount while others may not. You should contact your supplemental insurer to find out whether or not your plan helps pay for these expenses.

In hardship cases, you may also be able to get some or all of your remaining 20% deductable covered by our special assistance program if you meet the specific criteria to qualify for further assistance.

How to Order Your Diabetic Supplies

If you are Medicare eligible and have been diagnosed with diabetes by a physician, you can contact us to qualify for your diabetes testing supplies at little or no cost.

Just call us at 1-800-908-CARE (2273) or fill out the form on this page to get started.

Once you qualify, we'll work with Medicare and your doctor to take care of all of the necessary paperwork and then will immediately ship your diabetic supplies directly to your door. For your convenience, we’ll cover the cost of the shipping for you!

Then just reorder to replenish your supplies by calling us back or filling out the reorder form on this website before the end of every 90 day supply period. Don’t worry, we’ll remind you when it’s time to reorder so you won’t forget.

Medicare Eligilibilty

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance).

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A.

If you are under age 65, you can get Part A without having to pay premiums if:

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.)
• You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months. To be eligible for benefits, the individual must first meet the annual $155 Part B deductible.

If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration.

Their toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778.

You can also get information about buying Part A and Part B if you do not qualify for premium-free Part A.

Can I get Medicare if I am under age 65?

If you are under age 65 and disabled, and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you will be automatically entitled to Medicare Part A and Part B beginning the 25th month of disability benefit entitlement. You do not need to do anything to enroll in Medicare. Your Medicare card will be mailed to you about 3 months before your Medicare entitlement date.

You may refuse Part B coverage. However, if you decide to pick up Part B coverage at a later date, but before you turn 65, you may have to pay a 10% surcharge in addition to the Part B premium. Also, please be aware that you will automatically be re-enrolled in Part B when you turn 65, even if you previously refused Part B coverage. You may again refuse coverage, but if you keep it you will not have to pay a surcharge.

Note: A Special Enrollment Period is available if you waited to enroll in Medicare Part B because you or your spouse were working AND had group health coverage through a current employer or union. If this applies, you can sign up for Medicare Part B:

1. While you are still covered by an employer or union group health plan, through your or your spouse's employment, or
   
   
2. During the 8 months following the month when the employer or union group health plan coverage ends or when the employment ends (whichever comes first).

The Social Security Office can answer questions about applying or appealing Social Security Disability benefits. They can also answer questions about when you will be eligible to receive Medicare.

Your 24-month waiting period will be waived if you have been diagnosed with ALS (Amyotrophic Lateral Sclerosis). This disease is commonly known as Lou Gehrig’s Disease.

Will my non-working spouse, who turns 65 before me, get Medicare at 65?

If my spouse has never worked, and he/she turns 65 before I do, can he/she get Medicare at age 65? Or, does he/she have to wait until I turn age 65 and am on Medicare?

If you are at least age 62 and have worked for at least 10 years in Medicare-covered employment, your spouse can get Medicare Parts A and B at age 65. If you have worked at least 10 years in Medicare-covered employment but are not yet age 62 when your spouse turns age 65, he or she will not be eligible for premium-free Medicare Part A until your 62nd birthday.

In this case, your spouse should still apply for Medicare Part B at age 65 so that he/she can avoid paying a higher Part B premium.

However, if you are still working and your spouse is covered under your group health plan, he/she could delay enrollment in Part B without paying higher premiums.

Additional diabetic services Medicare covers

1. Diabetes Self-Management Training: Diabetes outpatient self management training is a covered program to teach you to manage your diabetes. It includes education about self-monitoring of blood glucose, diet, exercise, and insulin.
   
   If you’ve been diagnosed with diabetes, Medicare may cover up to ten hours of initial diabetes self-management training.
   
   You may also qualify for up to two hours of follow-up training each year if:
   
   • it is provided in a group of 2 to 20 people*,
   • it lasts for at least 30 minutes,
   • it takes place in a calendar year following the year you got your initial training, and
   • your doctor or a qualified non-physician practitioner ordered it as part of your plan of care.
   
   *Some exceptions apply if no group session is available or if your doctor or qualified non-physician practitioner says you have special needs that prevent you from participating in group training.
   
   
2. Yearly Eye Exam: Medicare covers yearly eye exams for diabetic retinopathy.


3. Foot Exam: A foot exam is covered every six months for people with diabetic peripheral neuropathy and loss of protective sensations, as long as you haven’t seen a foot care professional for another reason between visits.


4. Glaucoma Screening: Medicare covers glaucoma screening every 12 months for people with diabetes or a family history of glaucoma, African Americans age 50 and older, or Hispanics age 65 and older.


5. Medical Nutrition Therapy Services: Medical nutrition therapy services are covered for people with diabetes or kidney disease when referred by a doctor. These services can be given by a registered dietitian or Medicare-approved nutrition professional and include a nutritional assessment and counseling to help you manage your diabetes or kidney disease.
   
   Medicare covers three hours of one-on-one counseling services the first year, and two hours each year after that. If your condition, treatment, or diagnosis changes, you may be able to get more hours of treatment with a doctor’s referral. A doctor must prescribe these services and renew your referral yearly if continuing treatment is needed into another calendar year.


6. Diabetes Screening (Fasting Plasma Glucose Test): Medicare covers tests to check for diabetes.

You pay nothing for the Diabetes Screening. These tests are available if you have any of the following risk factors:
• high blood pressure,
• dyslipidemia (history of abnormal cholesterol and triglyceride levels),
• obesity, or
• a history of high blood sugar.

Medicare also covers these tests if you have two or more of the following characteristics:
• age 65 or older,
• overweight,
• family history of diabetes (parents, brothers, sisters),
• a history of gestational diabetes (diabetes during pregnancy), or
• delivery of a baby weighing more than 9 pounds.

Based on the results of these tests, you may be eligible for up to two diabetes screenings every year. For more information about diabetes outpatient self-management training from a Medicare-certified program, routine foot care, glaucoma screening, eye exam for diabetic retinopathy, medical nutrition therapy services, or diabetes screening (Fasting Plasma Glucose Test) call your Medicare Carrier. For more information about diabetes outpatient self-management training in an outpatient facility, call your Fiscal Intermediary. To get their telephone number, call 1-800-MEDICARE (1-800-633-4227).

You pay 20% of Medicare-approved amounts for outpatient facility charges or doctor services.

Other Diabetic Supplies Covered By Medicare

Medicare doesn’t cover insulin (unless used with an insulin pump), insulin pens, syringes, needles, alcohol swabs, gauze, eye exams for glasses, and routine or yearly physical exams. If you use an external insulin pump, insulin and the pump could be covered as durable medical equipment.

There may be some limits on covered supplies or how often you get them. Insulin and certain medical supplies used to inject insulin are covered under Medicare prescription drug coverage.

Therapeutic Shoes or Inserts: Medicare covers therapeutic shoes or inserts for people with diabetes who have severe diabetic foot disease. The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts. The shoes and inserts must be prescribed by a podiatrist or other qualified doctor and provided by a podiatrist, orthotist, prosthetist, or pedorthist.

Medicare helps pay for one pair of therapeutic shoes and inserts per calendar year. Shoe modifications may be substituted for inserts. The fitting of the shoes or inserts is covered in the Medicare payment for the shoes.