What You Need to Know

Approximately 25 percent of Americans over the age of 60 have diabetes, both diagnosed and undiagnosed. This condition often impacts older adults due to lifelong eating and lifestyle habits that can lead to high blood glucose levels.

In fact, one in every three Medicare beneficiaries has diabetes, and over 3 million use one or more types of insulin. The high cost of insulin and diabetes medication can make it difficult for seniors to manage the disease, increasing their risk for severe complications such as kidney failure, heart attacks, vision loss, and foot ulcers that could lead to amputation.

If you’re a senior, you might wonder if Medicare covers diabetes-related medical services and supplies. Both Part B and Part D offer coverage. Here’s what each plan includes:

Part B – Medical Insurance

Part B covers services and preventive measures for people with diabetes, including:

• Diabetes screenings for at-risk patients
• Foot exams and treatments
• Glaucoma tests
• A once-per-lifetime prevention program
• Diabetes self-management training
• Blood sugar or glucose testing monitors and infusion pumps
• Insulin pumps
• Therapeutic shoes or inserts

You must have Part B to receive these services and supplies.

Part D – Prescription Drug Plan

Part D covers diabetes-related supplies such as:

• Anti-diabetic drugs to maintain blood sugar levels
• Injectable insulin
• Medical supplies for injecting or inhaling insulin, including syringes, needles, alcohol swabs, gauze, and inhaled insulin devices

You need to be enrolled in a Medicare drug plan to receive these supplies under Part D.

Part D Senior Savings Model

The Part D Senior Savings Model, introduced by The Centers for Medicare & Medicaid Services (CMS), aims to reduce prescription drug costs. Starting January 1, 2021, it offers a broad set of plan-formulary insulins for a $35 copay for a 30-day supply throughout the deductible, initial coverage, and coverage gap phases of the Part D benefit. This model is expected to save beneficiaries who take insulin an average of $446 per year on out-of-pocket costs. The model runs until December 31, 2025, but participating plans may change each year.

Medicare Supplement (Medigap) or Medicare Advantage

Medicare Supplement plans may cover some diabetes services costs. Medicare Advantage Plans must provide the same coverage as Original Medicare Plan B but may have different rules.

Managing diabetes is crucial to prevent serious health issues. It’s essential to find the right Medicare Plan that fits your healthcare needs. Bruce can help you explore all the options available in our area.

Bruce Gleason
Medicare Lic. # 7279927 | (716)708-9943 | https://medcarevalue.com/BruceAGleason

Article provided by MedCareValue