Does Medicare Cover Glucose Control Solutions?
Medicare helps cover the cost of glucose control solutions as a necessary supply for durable medical equipment — your blood sugar monitoring system. You have to have Medicare Part B medical insurance and be diagnosed with diabetes, and your supplier must accept Medicare.
|Medicare Plan||Coverage for Glucose Control Solutions|
|Part A (Inpatient)||N/A|
|Part B (Outpatient)||Covers 80% of glucose control solution costs for qualifying diabetics. Part B deductible applies.|
|Part C (Medicare Advantage)||Coverage mirrors Part B. Select plans may offer additional benefits.|
|Part D (Prescription Drugs)||N/A|
|Supplemental Insurance||Can help cover out-of-pocket supply costs. Coverage varies by plan.|
Medicare Coverage of Glucose Control Solutions
After you pay your deductible, Medicare Part B medical insurance will cover 80 percent of the cost of your glucose control solution if you meet certain conditions. You will be responsible for the remaining 20 percent.
- You must be treated for diabetes.
- You must use the solution with a blood monitoring system that meets Medicare’s definition of durable medical equipment.
- Your doctor must accept Medicare.
- The supplier of the solution and your blood monitoring system must be enrolled in Medicare and accept Medicare-approved prices for the solution.
Medicare Part B will cover its share of the glucose control solution whether you rent or buy the glucose monitoring system you use.
It doesn’t matter whether or not your diabetes requires you to use insulin. Medicare will help cover glucose control solution costs so long as you are diagnosed with diabetes and your qualifying doctor prescribes a blood glucose monitoring system for you.
A Medigap — also known as Medicare Supplement insurance — policy can help cover your out-of-pocket costs for deductibles, coinsurance and copayments. Medicare Advantage plans also cover everything Original Medicare covers but may include additional benefits.
Both Medigap and Medicare Advantage plans are sold by private insurers. Check with your plan’s administrator to find out how your plan may help you cover the cost of glucose control solutions.
Medicare and Supplies for Diabetes Durable Medical Equipment
Medicare typically does not cover some disposable diabetes supplies, including needles, syringes and alcohol swabs. But it does cover supplies that are necessary for durable medical equipment (DME) to function.
- Durable — meaning it can hold up to repeated use
- The device has an expected lifespan of at least three years
- Must be used for a medical reason
- Typically is not useful to someone who is not sick or injured
- Must be used in your home
Medicare categorizes the monitors as durable medical equipment, and glucose control solutions are necessary for maintaining the devices.
Do You Need Glucose Control Solutions?
It may be necessary to test your equipment from time to time to make sure it is working properly and giving you accurate readings on your blood sugar levels.
Glucose control solutions ensure that your glucometer or other monitoring system and test strips are working properly. The solution contains a precise amount of glucose. If your machine doesn’t read that amount properly, then there could be a problem with the device.
- The container for your test strips appears damaged or not properly sealed.
- The results shown on your test strips don’t match how you’re feeling.
- Whenever you drop, damage or get your meter wet.
- Your blood sugar meter or test strips were exposed to high heat or humidity, cold temperatures or sunlight.
- Your doctor or other health care professional advises you to test your meter.
- You think your glucose meter or your test strips aren’t working.
Be aware that a glucose control solution test will not tell you how accurate your glucose meter is, nor will it calibrate your meter. The test is used simply to make sure the meter and test strips are working the way their manufacturers intended.
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
- Amin, S. (2020, July 16). Does Medicare Cover Diabetes Supplies? Retrieved from https://www.medicalnewstoday.com/articles/does-medicare-cover-diabetic-supplies
- 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. (n.d.). Durable Medical Equipment (DME) Coverage. Retrieved from https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Glucose Control Solutions. Retrieved from https://www.medicare.gov/coverage/glucose-control-solutions