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Managing Diabetes with Medicare: What You Need to Know

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Managing Diabetes with Medicare: What You Need to Know
If you have diabetes, your body either doesn’t make enough insulin or doesn’t respond to insulin properly. Insulin is the hormone that helps turn sugars, starches, and other foods into the energy you need to live. Without enough insulin, your blood sugar can become too high, which can be harmful to your health.

Untreated diabetes can lead to serious health problems. According to the American Diabetes Association, more than 37 million Americans were living with diabetes in 2019, with nearly 30% of people aged 65 and older affected. It’s also the seventh leading cause of death in the United States.
 
The Good News: Managing Diabetes
The good news is that diabetes can be managed. Early detection and treatment can help prevent or delay many of the health issues related to diabetes. A combination of healthy eating, regular physical activity, and modern medications can make a significant difference.
 

What Does Medicare Cover for Diabetes?
If you have diabetes or are at risk for it, Medicare offers a range of benefits to help manage your condition:

 
Diabetes Screenings: Medicare Part B covers up to two screenings per year if you’re at risk for diabetes.
 
Medications and supplies: Medicare Part D covers insulin, diabetes drugs, and some supplies. However, insulin used with external pumps is covered under Medicare Part B.
 
Support services: Medicare covers various services, such as diabetes management training and nutritional counseling.
 
 
What Medicare Does NOT Cover
While Medicare covers many essential services and supplies for managing diabetes, it does not cover everything. For example:
 
 
Routine eye exams for glasses: These are not covered, but Medicare does cover a dilated eye exam once every 12 months to check for diabetes-related eye damage.
 
Routine physical exams: After the initial “Welcome to Medicare” exam, Medicare will cover an Annual Wellness Visit each year.
 
Weight-loss programs: These are generally not covered.
 
It's important to follow Medicare’s rules, such as getting a doctor’s prescription for certain supplies and seeing approved providers. Not following these rules may result in having to pay the full cost of care.
Medicare-Covered Products and Supplies
Medicare helps cover the equipment and supplies to help control your blood sugar, including:
  • Blood sugar testing equipment
  • Supplies for taking insulin
  • Special orthopedic shoes(prescribed and fitted by a doctor or qualified professional)
Some supplies are covered under Medicare Part B, while others fall under Part D. Be sure to know the difference to go get your supplies on time and save money.
Getting Your Diabetes Supplies
Your doctor must give you a prescription for blood sugar testing equipment and insulin supplies. You can order these from a local pharmacy or a medical equipment supplier, but you must place the order yourself - your doctor cannot do this for you.
Preventative Services Covered by Medicare for People with Diabetes
Medicare also covers various preventative services, which can help manage diabetes and reduce complications. Some services require a doctor's order, such as:
  • Diabetes screenings
  • Diabetes self-management training
  • Nutritional counseling
  • Hemoglobin A1C tests
  • Special eye exams
Other preventative services do not require an order including:
  • Foot exams
  • Glaucoma tests
  • Flu and pneumonia shots
  • Annual wellness visit
Taking advantage of these health services can help you stay on top of your diabetes and overall health.

If you have any questions or need more information, visit Medicare.gov or contact the Medicare Helpline at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

 
To Learn More Visit Our Wellness Program

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