Coverage of Diabetic Supplies — Medicare Part B or Part D?

Most diabetic supplies, including blood sugar test strips, needles, pumps, etc., are covered under Medicare Part B, medical Insurance, as durable medical equipment (DME). However, some brand name diabetic supplies, such as Omnipod, may be covered under Medicare Part D plans, rather than Part B. 

If you take brand name diabetic supplies, be sure to check for Medicare coverage with your brand name supplier.

Ask the following questions of the manufacturer or your equipment supplier:

1. Are my supplies covered by Part B, medical insurance, or Part D, prescription drug plans?
2. If the answer is Part D, prescription drug plans, ask which specific Part D plans will cover the supplies you need for the next year.
   IMPORTANT: You will not be able to enter these supplies in HeyMOE (or the Medicare.gov Plan Finder tool) as medications. You must compare rely on the supplier to compare coverage in Part D plans.

Additional resource links:

• Optipod Part D coverage: https://www.omnipod.com/is-omnipod-right-for-me/coverage/medicare
• Mentronic InPen Part D coverage: https://www.medtronicdiabetes.com/medicare-faqs

If your supplies are covered under Medicare Part B, you must get the equipment from a supplier who accepts Medicare assignment. You will pay 20% of the Medicare-Approved Amount after the Part B deductible is met, unless you have a Medigap policy that covers the Medicare coinsurance. Check the listing of suppliers who accept Medicare at https://www.medicare.gov/medical-equipment-suppliers/

Please note: Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. 

Check this link for more information. 

• Medicare and Blood sugar test strips—www.medicare.gov/coverage/blood-sugar-test-strips
• Diabetic Supplies— www.medicare.gov/publications/11022-medicare-coverage-of-diabetes-supplies-services-and-prevention-programs.pdf

What to do:

1. Enter all your other prescriptions into HeyMOE and let it identify the plan with the lowest total cost.
2. Take that plan name and visit the Omnipod Medicare page:
   ? https://www.omnipod.com/is-omnipod-right-for-me/coverage/medicare
   There’s a button on that page to have one of their specialists call you. Let them know which plan HeyMOE recommended—they can tell you if that plan covers the Omnipod 5.
3. Omnipod also lists plans they believe will cover the device, but I’d still confirm with both the plan provider and the Omnipod team directly—coverage details can vary and change.