Does Medicare Cover Diabetes Supplies and Continuous Glucose Monitors?

The Part B and Part D Split

Item	Covered under	Your usual cost
Meter, test strips, lancets	Part B	Deductible, then 20%
Continuous glucose monitor and sensors	Part B	Deductible, then 20%
External insulin pump (durable equipment)	Part B	Deductible, then 20%
Insulin pens, syringes, needles, swabs	Part D	Your plan’s cost sharing

When people ask “does Medicare cover diabetes supplies,” the honest answer depends on the item. Here is how Medicare divides it, according to its official diabetes coverage booklet:

• Part B covers blood glucose meters, test strips, lancets and lancet holders, control solutions, continuous glucose monitors and their sensors, and external insulin pumps that qualify as durable medical equipment.
• Part D covers insulin pens and injectable insulin, plus supplies used to inject it, such as syringes, needles, alcohol swabs and gauze. Part B does not cover those. The exception is insulin used with a traditional external pump that qualifies as durable medical equipment: Part B covers that insulin along with the pump.

This matters because the two parts have different cost rules. Part B items are generally subject to the Part B deductible and then 20% of the Medicare-approved amount. Part D items depend on your drug plan’s tiers and copays. If you have Medicare Advantage, your plan usually combines both, but it still has to cover what Original Medicare covers. Our guides to Medicare Part B and Medicare Part D explain the broader differences.

Meters, Test Strips and Lancets

If you check your blood sugar with finger sticks, Part B treats your meter and supplies as durable medical equipment. The amounts it covers depend on whether you use insulin:

• If you use insulin, Medicare may cover up to 300 test strips and 300 lancets every three months.
• If you do not use insulin, the limit is up to 100 test strips and 100 lancets every three months.
• If your doctor documents that you need more, Medicare may allow additional supplies. Expect to keep a record of how often you actually test.

To get covered, you need a prescription from your doctor or another treating provider. It should state that you have diabetes, what equipment you need and why, whether you use insulin, how often you should test, and how many strips and lancets you need each month. Medicare requires a new prescription for strips and lancets every 12 months, and you have to request refills yourself. Medicare will not pay for supplies you did not ask for, including items that are mailed to you automatically.

Continuous Glucose Monitors

A CGM tracks your glucose through a small sensor worn on your body, sending readings to a receiver or a phone. Medicare covers these under Part B as durable medical equipment when your doctor orders one and you meet the conditions.

Who qualifies. You must have diabetes and meet both of the following:

• You take insulin, or you have a history of problematic low blood sugar (hypoglycemia). Coverage used to be limited to people on multiple daily insulin injections, but Medicare broadened it so that people using any kind of insulin can qualify, and so can some people who do not take insulin but have a documented history of serious low blood sugar events. The coverage policy defines “problematic” hypoglycemia with specific criteria, so your doctor will need to document it.
• You or your caregiver has had enough training to use the device.

Ongoing visits. Before the order, your treating provider needs to evaluate you, and under the coverage policy that visit, in person or by Medicare-approved telehealth, generally has to happen within the six months before the order. Once you are using a CGM you need to keep up routine visits, and the policy calls for one about every six months, so scheduling them matters. If you miss them, your supplier may not be able to keep billing Medicare. Our post on Medicare telehealth coverage explains what virtual visits are allowed.

What is included. Coverage includes the monitor and its related supplies, such as sensors. Depending on the device, you may be able to rent it, buy it, or choose between the two.

What you pay. After you meet the Part B deductible, which is $283 for the current year, you generally pay 20% of the Medicare-approved amount, provided the supplier accepts assignment. That means the supplier agrees to charge only the Medicare-approved price. A supplier that does not accept assignment can charge more, and in that case you may be asked to pay upfront.

One caution. Some CGM products are sold over the counter, directly to consumers, without a prescription. Medicare’s coverage rules are written around prescribed devices from enrolled suppliers, so do not assume a retail purchase will be reimbursed. Ask your doctor and your plan before you buy.

Where to Get Your Supplies

You can generally get Part B diabetes supplies from a pharmacy or from a medical equipment supplier, as long as the one you choose participates in Medicare and accepts assignment. Before you order, ask two questions: do you participate in Medicare, and do you accept assignment? If the answer to either is no, you could end up paying the entire charge yourself.

Mail-order suppliers are common for strips and CGM sensors, and many people like the convenience. Medicare’s supplier directory and 1-800-MEDICARE can help you find one that participates. In some parts of the country, Medicare requires specific suppliers for certain equipment, such as durable insulin pumps, so ask when you start.

Be careful about unsolicited offers. Fraudulent suppliers sometimes advertise “free” glucose monitors or call out of the blue, and then bill Medicare using your number. If a company contacts you that you did not choose, do not give out your Medicare number. Our post on Medicare fraud and scams explains what to look for.

If You Have Medicare Advantage

A Medicare Advantage plan has to cover everything Original Medicare covers, but it manages that coverage differently. Some points to check:

• Network suppliers. Your plan may require you to use certain pharmacies or equipment suppliers for strips and CGMs. Using one outside the network could mean higher cost sharing or no coverage.
• Brand and device rules. Plans sometimes prefer particular meters or CGM brands, and may require you to try a specific one first.
• Prior authorization. Some plans require approval for CGMs or pumps. See how that process works in our guide to Medicare Advantage prior authorization.
• Cost sharing. Instead of 20% coinsurance, your plan may charge a flat copay. Look in your Evidence of Coverage for the “durable medical equipment” section.

With Original Medicare and a Medigap policy, some or all of the 20% that Part B leaves to you may be covered, depending on the plan letter. Our page on Medicare Supplement Plan G shows how one of the most common plans handles it.

Beyond Supplies: Other Diabetes Services

Equipment is only part of what Medicare offers if you have diabetes, or are at risk of it. The Medicare booklet lists several other covered services, and these are easy to overlook:

• Diabetes self-management training. Part B covers up to 10 hours of initial training (usually 1 hour individual and 9 hours group) that you complete within 12 months of starting, plus 2 hours of follow-up training each year after the year you get the initial training. You need a written order from your provider, and the usual Part B deductible and 20% coinsurance can apply.
• Medical nutrition therapy. If you have diabetes or kidney disease and a doctor refers you, a registered dietitian can provide nutrition counseling.
• Hemoglobin A1C tests. Part B covers them when your doctor orders them, and you pay nothing for Medicare-covered lab tests.
• Diabetes screenings. If you are at risk, Medicare covers up to two screenings a year.
• Glaucoma screening. People with diabetes are at higher risk, and Part B covers a screening once every 12 months for people at increased risk, a group that includes people with diabetes. An eye doctor legally allowed to perform it in your state must give or supervise it.
• Foot exams. Part B covers a foot exam by a podiatrist or other foot care specialist every six months if you have diabetic peripheral neuropathy with loss of protective sensation, meaning diabetes-related nerve damage in the lower leg that raises the risk of limb loss, as long as you have not seen a foot care professional for another reason in between.
• The Medicare Diabetes Prevention Program. For people with prediabetes who meet specific criteria, this lifestyle program is covered at no cost.

Some of these services involve cost sharing and some do not. Ask the office what you will owe before you schedule.

A Short Checklist Before You Order

• Confirm your prescription includes everything Medicare asks for, including whether you use insulin.
• Ask the supplier whether it participates in Medicare and accepts assignment.
• If you are in Medicare Advantage, call your plan or check its supplier directory first.
• Keep track of your required follow-up visits so coverage does not lapse.
• Do not accept supplies that arrive unrequested.

Frequently Asked Questions

Does Medicare cover glucose test strips?

Yes. Part B covers test strips, lancets and meters for people with diabetes, with limits on quantity depending on whether you use insulin. You need a prescription, and you generally pay 20% after the Part B deductible.

Do I have to use insulin to get a CGM covered?

Not necessarily. Coverage is available if you take insulin or have a documented history of problematic low blood sugar. Your doctor must evaluate you and document that you meet the requirements.

Does Part D or Part B cover insulin needles and syringes?

Part D, not Part B, covers insulin pens and the supplies used to inject insulin, such as needles, syringes, alcohol swabs and gauze. You pay according to your plan’s cost sharing. The exception is insulin used in a traditional external pump covered as durable equipment, which falls under Part B.

Will Medicare Advantage cover a CGM?

Medicare Advantage plans must cover what Original Medicare covers, but they can use networks, preferred brands and prior authorization. Check your plan’s rules and your Evidence of Coverage.

Can I buy a CGM over the counter and get reimbursed?

Possibly not. Medicare’s coverage is written around devices that are prescribed and supplied by enrolled suppliers. Ask your doctor and your plan before buying one on your own.