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How Does Medicare Cover Diabetes?

Diabetes is one of the most chronic medical conditions that can be difficult to manage. According to the CDC, more than 37 million American adults have diabetes, while 96 million are prediabetic. For persons with diabetes, getting quality medical care services and medical supplies is essential to leading a happy, healthy life. However, diabetes management can quickly become expensive, particularly for older adults. Luckily, Medicare offers coverage for most diabetes healthcare services, medications, and supplies.

Medicare Part B pays for blood glucose testing expenses, select supplies, and some education and medical services. On the other hand, Medicare Part D covers medications and supplies for inhaling or injecting insulin.

While it can largely depend on your plan, Medicare covers 80% of most diabetes medical services and supplies after you meet the deductible required in Part B. Therefore, you will pay 20% of the Medicare-agreed amount for diabetes medical services.

Here’s a breakdown of the diabetes medical services and supplies that Medicare covers:

Foot Care for Diabetes

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Nearly half of people with diabetes experience nerve damage, which commonly affects the feet. Thus, regular foot care is needed to remain happy and healthy. That’s why Medicare caters for foot care services for older adults with diabetes – under certain circumstances.

According to the CDC, if a person with diabetes experiences nerve damage in their lower leg that can lead to limb loss, Medicare pays for an annual foot exam, as long as the patient hasn’t seen a foot care professional for other reasons during their Medicare-scheduled visits.

If you need a particular set of diabetic shoes, Medicare Part B will take care of the cost of the fitting of either a set of additional depth shoes or a pair of tailor-made shoes and inserts. This happens every year and only applies to people with severe diabetic foot disease. In addition, Medicare may pay for two extra sets of inserts for tailor-made shoes, shoe adjustments, or three sets of inserts for additional depth shoes.

Eye Exams and Glasses

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Routine eye exams are an essential aspect of diabetes care. Medicare pays for annual eye examinations for diabetic retinopathy for people with diabetes. Nevertheless, the exam must be performed by an eye specialist who is legally allowed to conduct these tests in your state. To get a Medicare-accredited eye specialist in your state, you can browse the Medicare’s official website or contact your Medicare Advantage Plan’s services team for help.

In contrast, Original Medicare limits its coverage for eyewear. Eye exams and glasses are only available to patients who have undergone cataract surgery. But unlike Original Medicare, Medicare Part C offers additional benefits, such as vision services. Although Plan offers differ, most cover or provide discounts for contacts or glasses.

Diabetic Nutrition Services

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If you need help forming and sticking to a healthy diet, Medicare covers medical nutrition services for those with diabetes. This might include:

  • A nutrition and lifestyle evaluation
  • Personal or group therapy
  • Programs aimed at promoting healthy lifestyle changes
  • Follow-up visits to evaluate your nutrition

Keep in mind that only a registered nutrition specialist can offer diabetic nutrition therapy services included in Medicare. If you find it challenging to get into an office, you can get the nutrition services you need through telehealth, an incredible option for those who cannot access dependable transportation or live in rural areas.

Medical nutrition therapy and diabetes self-regulation training are the two common medical programs covered by Medicare. Both programs differ, but they are aimed at helping people with diabetes live happier and healthier lives. Medical nutrition therapy is a diabetes education program that offers treatment with a registered nutritionist or dietitian. It offers nutrition diagnosis and counseling services to help patients manage diabetes. This service is considered preventive, and qualifying patients don’t pay for therapy.

In contrast, diabetes self-management training is an outpatient diabetes training program that offers guidance on everything associated with diabetes, including nutrition. Medicare covers 10 hours of the program’s preliminary training and two hours of supplementary training annually.

Medicare Coverage for Medicine, Pumps, Insulin, Syringes and Needles

Original Medicare doesn’t pay for diabetes oral medications and insulin unless your doctor deems an insulin pump medically necessary. Additionally, it doesn’t cover insulin pens, needles, syringes, and other supplies. Nonetheless, Medicare Part D pays for these supplies, so signing up for a comprehensive Medicare plan on this website is an integral aspect of care.

Medicare Coverage for Blood Sugar Self-Testing Supplies

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People with diabetes may need to test their blood sugar levels at home. Medicare caters for blood sugar testing supplies, including glucose monitors, test strips, continuous glucose monitors, lancet and lancet devices. However, you need a prescription from your doctor for your testing supplies. In addition, you will need refills and a new prescription from your doctor every year. Remember, you have to buy your supplies from a Medicare-approved pharmacy.

In the realm of diabetes management, a comprehensive approach includes not only diligent self-care practices but also a thorough assessment of Medicare coverage to ascertain its adequacy in addressing individual needs. Taking charge of one’s health requires a proactive stance in understanding the components of Medicare coverage that contribute to effective diabetes management.

As individuals navigate the complexities of diabetes, it becomes paramount to review their Medicare coverage periodically. This involves a meticulous examination of the specific benefits, prescription drug coverage, and any other provisions that relate directly to diabetes care. Understanding the nuances of coverage ensures that individuals have access to the necessary medications, devices, and services crucial for managing their condition effectively.