Does Medicare Cover Blood Sugar Monitors and Supplies?
Original Medicare helps cover the cost of blood sugar monitors and a monthly supply of blood sugar test strips if your doctor prescribes a monitor for use in your home. The blood sugar monitor and test strips are covered as durable medical equipment under Medicare.
Your Costs for a Blood Sugar Monitor Under Medicare
Medicare Part B covers blood sugar monitors — also called blood glucose monitors — for beneficiaries with diabetes. You are responsible for your Part B deductible and 20 percent of the Medicare-approved costs. Medicare will cover the remaining 80 percent.
A doctor has to prescribe a monitor for use in your home, and you have to meet certain other eligibility requirements before Medicare will cover blood sugar monitors and test strips.
- You must be in treatment for diabetes.
- Your doctor must accept Medicare.
- Your supplier must be enrolled in Medicare and accept assignment — meaning they are willing to accept the Medicare-approved price for the monitor and test strips.
If your supplier does not participate in Medicare, they can charge you whatever they want, and Medicare will not pay for it.
Blood glucose monitors are covered under Medicare’s definition of durable medical equipment (DME).
- Durable — able to withstand repeated use
- Typically has an expected lifespan of three years or more
- Used in your home
- Used for a medical reason
- Not typically useful for someone who is not sick or injured
Medigap and Medicare Advantage May Affect Your Out-of-Pocket Costs
A Medigap policy or a Medicare Advantage plan may cover some of your out-of-pocket costs that Original Medicare does not cover.
A Medigap — or Medicare Supplement insurance — policy can help cover your deductible, coinsurance and any copayment related to a blood sugar monitor and test strips. Medigap plans supplement your coverage if you have Original Medicare.
Medicare Advantage plans replace Original Medicare and are required to cover everything that Medicare Part A and Part B cover. But they may provide extra benefits that Original Medicare does not.
Both Medigap and Medicare Advantage plans are sold by private insurers, and coverage can vary depending on the plan. Talk with your plan’s administrator about what specific coverage your plan may provide when it comes to blood sugar monitors, test strips and other diabetes supplies.
Medicare Covers Blood Sugar Test Strips
Medicare Part B also covers all supplies necessary for the proper use of durable medical equipment. As a result, Medicare Part B covers blood sugar test strips along with lancets and lancet devices. But there may be limits on the number of test strips or other supplies Medicare will cover.
- If you use insulin: Medicare will cover up to 300 test strips and 300 lancets every three months.
- If you do not use insulin: Medicare will cover up to 100 test strips and 100 lancets every three months.
- Medicare will cover more than the limited number if your doctor declares additional test strips and lancets are medically necessary. You may need to keep records of your self-treatments to show to Medicare as proof.
Your cost for supplies follows the same formula as for the monitor — you are responsible for your Part B deductible and 20 percent of the amount charged, while Medicare covers the remaining 80 percent — as long as your doctor and supplier participate in Medicare.
Blood Sugar Monitor vs. Continuous Glucose Control Monitor
For some Medicare beneficiaries with diabetes, a continuous glucose control monitor (CGM) may be a better option than a blood sugar monitor.
But Medicare will pay to replace your blood sugar monitor with a CGM only if you meet certain criteria. These include taking insulin, using an insulin pump and needing to check your blood sugar levels four or more times a day.
You should talk with your doctor to see if you qualify for a continuous glucose control monitor and if it is a better option for you.
6 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2020, December). Medicare Coverage of Diabetes Supplies, Services and Prevention Programs. Retrieved from https://www.medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf
- U.S. Centers for Medicare & Medicaid Services. (2019, December). Medicare Coverage of Diabetes Supplies, Services and Prevention Programs. Retrieved from https://www.medicare.gov/Pubs/pdf/11022-LE-Medicare-Coverage-of-Diabetes.pdf
- U.S. Centers for Medicare & Medicaid Services. (2018, August 16). Current Medicare Coverage of Diabetes Supplies. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE18011.pdf
- U.S. Centers for Medicare & Medicaid Services. (2015, December 21). Medicare Coverage of Blood Glucose Monitors and Testing Supplies. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1008.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Blood Sugar Test Strips. Retrieved from https://www.medicare.gov/coverage/blood-sugar-test-strips
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Blood Sugar Monitors. Retrieved from https://www.medicare.gov/coverage/blood-sugar-monitors