Some beneficiaries elect to receive their Medicare coverage through a private health insurance company rather than the government. This option is known as Medicare Part C, or Medicare Advantage. All Medicare Advantage plans provide the same diabetes coverage as Medicare Part B. In addition, most also provide Part D benefits as part of their health plan. In the event a Medicare Advantage plan does not include this coverage, a beneficiary must purchase a separate prescription drug plan to cover anti-diabetic drugs, insulin and related supplies. Like Part D plans, Medicare Advantage policies can set their own co-payment and coinsurance rates.
Medicare: American Diabetes Association®
Some beneficiaries choose Medicare Advantage plans instead of Medicare Part A and B (the “Original Medicare Plan”). A Medicare Advantage Plan is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits. Because Medicare Advantage plans are private insurance plans, they come in all shapes and sizes. Out-of-pocket costs vary depending on the plan. Most plans offer prescription drug coverage and plans may offer extra benefits that are not covered under Parts A and B (but you may pay extra for them).
Medicare Coverage for Diabetes Supplies
As a Medicare patient, you have certain guaranteed rights. You have them whether you are in the Original Medicare Plan, a Medicare Managed Care Plan, or a Medicare Private Fee-for-Service plan. These rights and protections are described in your Medicare & You handbook and include the right to appeal any decision about your Medicare services. For more detailed information about your rights and protections, call 1-800-MEDICARE (1-800-633-4227) to get a free copy of the booklet Your Medicare Rights and Protections.
Medicare Coverage of Diabetes
Diabetes supplies for blood sugar monitoring: Medicare Part B covers certain supplies for testing your blood sugar, such as blood sugar test strips, lancets, and blood sugar monitors. Medicare may limit the amount and frequency of your diabetes supply purchases, depending on whether you take insulin. You pay 20% of the amount approved by Medicare for these diabetes supplies, subject to the Medicare Part B deductible.