Medicare Coverage of Glucose Monitors
This article was updated on: 09/10/2018
What are glucose monitors used for?
If you have been diagnosed with diabetes, a glucose monitor can help you manage your disease and prevent complications, according to the National Institutes of Health (NIH). A glucose monitor measures your blood sugar (glucose) levels so you can make informed decisions about eating, exercising, and taking prescription medications, such as insulin.
According to the NIH, one way to monitor your glucose levels is by using a finger-stick device to collect a drop of blood, which you put into a glucose monitor on a set schedule each day. An alternative site glucose monitor allows blood samples from areas such as your palm or thigh, according to the Mayo Clinic. As well as a glucose monitor, you may also need other testing supplies, such as lancets, glucose test strips, and a glucose control solution.
Medicare coverage of glucose monitors
Under Original Medicare (Part A and Part B), Part A covers health-care expenses you incur as an inpatient in a hospital, while Part B covers your outpatient care, including some glucose monitoring supplies and durable medical equipment. Medicare does not generally cover “continuous glucose monitoring,” which (according to the NIH) involves a sensor inserted under your skin for several days to a week.
If your health-care provider recommends a different way to monitor your blood sugar other than the finger-stick glucose monitor, you might want to check with Medicare to see whether it’s covered. You can reach a Medicare representative 24 hours a day, seven days a week, if you call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. If you have a Medicare Advantage plan, call your plan to ask about this coverage.
How does Medicare treat durable medical equipment?
Medicare treats glucose monitors and blood sugar test strips as durable medical equipment (DME) under Medicare Part B. If your physician prescribes glucose monitoring at home, your durable medical equipment costs are generally covered at 80 percent of the Medicare-approved
amount, once your deductible is met.
Keep in mind, however, that under Medicare Part B, your glucose monitoring equipment and supplies will only be covered if both your health care provider and DME vendor accept Medicare assignment. If you live in area affected by Medicare’s Competitive Bidding Program, you generally need to use a Medicare-contracted supplier.
Are there other options for Medicare coverage of glucose monitors?
Some Medicare beneficiaries choose to receive their Original Medicare benefits (except hospice care) through the Medicare Advantage (Medicare Part C) program. Part A covers hospice care when you have a Medicare Advantage plan. Medicare Advantage plans cover glucose monitors in the same way as Medicare Part B and often offer additional benefits, such as vision, dental, and prescription drug coverage. Some types of Medicare Advantage plans use provider networks, and may reduce the amounts you pay to monitor your glucose levels at home with a glucose monitor. In any case, when you’re enrolled in a Medicare Advantage plan, you’re still in the Medicare program, and must continue paying your Medicare Part B monthly premium, as well as any premium the Medicare Advantage plan may charge.
If you decide to stay with Original Medicare, another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs for glucose monitors and other items and services. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.
Would you like to know more about Medicare coverage of glucose monitors?
If you have questions about Medicare coverage for home glucose monitors, or would like more information about Medicare plan options to help you better plan for your expenses, I’d be happy to discuss them with you. If you’d like to schedule a phone call, or request a personalized email, click on the corresponding button below. The “Compare Plans” button on the page will show you some of the Medicare plan options available in your area.
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