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What Do You Need to Know about Diabetes Medicare Costs?

Diabetes and Medicare Costs, Trusted Medicare Answers

Dealing with a chronic illness can be stressful and scary, especially if you don’t know how you’re going to pay for your treatment options. With the rising price of insulin, taking care of your diabetes Medicare costs seems more and more difficult. We can help show you how the right Medicare plan can relieve these worrisome money burdens. You deserve the most cost-effective coverage plan through Medicare to lead a happy and healthy life.

As someone with diabetes, obtaining supplemental insulin can be absolutely crucial for your health. Since 2002 the prices of these drugs have nearly tripled, with the current 2019 monthly cost hovering somewhere around $1,300 to $1,500. This is way too much for most people to handle out-of-pocket. Because of this, it’s absolutely vital to know what is covered by your Medicare plan so you’re not paying potentially thousands of dollars.

What all is covered by Medicare?

Part B of Medicare is responsible for covering a major portion of these costs associated with diabetes. Differing from person to person, part B can cover:

  • 80% of the price of insulin and insulin pumps, as this is the bulk of treatment needed to survive with diabetes.
  • Therapeutic shoes and inserts for those that need it.
  • Foot exams and treatments for resultant issues.
  • Blood glucose monitors for managing blood sugar.
  • Diabetes Self-Management Training (DSMT) that provide you with 10 hours of initial training and 2 hours of follow-up training to learn how to properly deal with your diabetes. Ask your doctor about this free service.
  • Supplemental medical nutrition therapy services to help you control your blood sugar through diet.

Part D of Medicare, the plan that covers medication and other treatments not included in part B, offers:

  • Insulin that is NOT administered via insulin pump.
  • Anti-diabetic drugs such as Sulfonylureas (Glipizide, Glyburide), Biguanides (Metformin), Thiazolidinediones (Pioglitazone, Troglitazone) and Alpha Glucosidase Inhibitors (Precose).
  • Injection supplies such as syringes, needles, alcohol swabs and gauze.
  • Inhaled insulation devices in place of insulin pumps.

Other diabetes Medicare costs covered are glaucoma tests, Welcome to Medicare preventative visits to make sure you have a plan to stay healthy, and annual wellness trips to the doctor.

If you have a Medicare Advantage Plan (part C), it covers the same services as Original Medicare (parts A&B). You may need to add a part D plan if prescription drugs are not already included in your Medicare Advantage Plan.

What isn’t covered by Medicare?

While finding the right plan can cover most of your diabetes Medicare costs, there are still some things that aren’t taken care of. For example, Medicare doesn’t cover eyeglass and eye exams, orthopedic shoes, and cosmetic surgeries. Based on the severity of your condition, you may be able to inject insulin (which is covered by part D), or your doctor might prescribe you to use an insulin pump. Medicare part B can only cover 80% of the costs of obtaining an insulin pump and the insulin needed, leaving you with a resultant 20% of costs that are unaccounted for. Unfortunately, in most cases the extra 20% of insulin pumps must be paid out-of-pocket, though there’s a chance it can be covered by a Medigap plan.  

What is the takeaway?

If changes to your condition requires you to alter your treatment plan, suddenly increasing your diabetes Medicare costs, you may qualify to switch to a plan that can give you better coverage with no penalties. You should consult one of our licensed representatives as soon as possible. A review of your coverage is free and there’s no obligation.