Medicare offers coverage for many different types of diabetes-related care. Most of this coverage comes from Part B or Part D. Part B is part of Original Medicare and offers medical insurance. It may cover things like screenings and supplies. Part D is a separate, optional plan offering prescription drug coverage. It may cover drugs that help manage blood sugar.
Aetna® Medicare Advantage plans and Special Needs Plans (SNPs) can offer extra support to meet diabetes care needs. For example, a Chronic Condition Special Needs Plan (C-SNP) can offer specialized care and support to help manage your condition.
Does Medicare cover diabetic supplies?
Managing diabetes can be a lot to deal with, but Medicare can help. If you have Medicare, diabetic supplies may be covered by Part B. Part D may also help pay for injectable insulin and other drugs that manage blood sugar levels.
What diabetic supplies and services are covered by Medicare Part B?
Part B handles most of the diabetic supplies covered by Medicare. This includes testing supplies, insulin (used with an insulin pump) and durable medical equipment. For example, if you needed a glucometer covered by Medicare, Part B could provide coverage. Here are some of the most common supplies Part B covers:
- Insulin (only if used with a pump that’s covered by Medicare)
- Glucose meters
- Glucose monitors
- Glucose test strips
- Lancets
- Insulin pumps
- Blood sugar test kit
After you pay your Part B deductible, you pay 20% of the cost for most of these supplies. For insulin, you pay $35 or less with Part B for a one-month supply if you use an insulin pump covered by Medicare.
Part B may also cover services that help you manage diabetes. The chart below outlines those services and how Part B covers them.
| Services and supplies covered by Part B | Costs out of pocket | Medicare coverage |
|---|---|---|
| Diabetes screenings | None | Covers up to 2 tests per year if your doctor believes you’re at risk for diabetes |
| Hemoglobin A1C tests | None | Covers up to 2 tests per year if your doctor believes you’re at risk for diabetes |
| Foot exams | 20% of Medicare-approved amount after you pay your annual part B deductible | Covers 1 foot exam every 6 months if you have peripheral neuropathy (a nerve problem that causes tingling and burning feelings) and do not see a foot care professional between exams |
| Medical nutrition therapy | None | May be covered if you have diabetes or kidney disease and your health care provider refers you |
| Flu vaccine | None | Covered once per flu season |
| Pneumonia vaccine | None | Covered (usually one time only) |
| Glaucoma tests | 20% of Medicare-approved amount after you pay your annual part B deductible | Covered every 12 months if you’re at risk for glaucoma |
| “Welcome to Medicare” visit | None | Covered once during the first 12 months you have Part B |
| Yearly wellness visit | None | Covered once per year if you have had Part B for longer than 12 months |
| Diabetes self-management training services | None | Covered if you were recently diagnosed with diabetes, are at risk for complications, and your health care provider orders these services |
| Insulin for external durable insulin pumps | Must pay Part B coinsurance unless you have a Medigap plan which covers it | Covered; you can get one month of supply at a time |
What diabetic supplies are covered by Medicare Part D?
Insulin is covered by Medicare Part D when it is injectable, inhalable, or used with a disposable insulin pump. But you need certain supplies to use it. Part D covers these supplies, including:
- Needles
- Gauze
- Diabetic syringes
- Alcohol swabs
- Disposable insulin pumps
If your plan has a Part D deductible, your coverage begins to help with these supplies after you pay for it. You may also have out-of-pocket costs like copays.
Looking for prescription drug support? Learn more about Aetna Medicare prescription drug plans.
Managing diabetes with an Aetna Chronic Condition Special Needs Plan (C-SNP)
Aetna Chronic Condition Special Needs Plans (C-SNPs) are made to fit your unique needs. With a C-SNP, you can get diabetes management training, nutrition therapy and telehealth options to help with your daily care. Your yearly eye exams and screenings are also covered. You can even get glucose monitors, test strips and insulin at no cost when you use in-network providers. Managing diabetes is easier with the coordinated care and support of an Aetna C-SNP. Find the right plan for your needs.
Weight management support for diabetes
Medicare can support your healthy lifestyle in many ways. But that doesn’t usually include weight management. While it is covered as a diabetes treatment, Medicare will not cover Ozempic® for weight loss. Other GLP-1s like Wegovy® and Zepbound® are also not covered if they’re used for weight loss. Obesity behavioral therapy is one treatment that may be covered by Part B if you qualify.
Need support for your weight loss journey? You can get added benefits like fitness programs with an Aetna Medicare Advantage plan.
How to check your Medicare plan for diabetic coverage?
If you have Original Medicare (Part A and B), you can check your coverage on the official Medicare website. If you have an Aetna Medicare plan, you can log in to view your current plan details. You can also use the Aetna Plan Finder to check coverage by ZIP code or plan name.
Don’t have an Aetna Medicare plan? Aetna offers specialized plans built to support your life with diabetes. Enroll in Medicare Advantage or a C-SNP plan to get more of the care you need.
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This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website.”
The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include certain cardiovascular disorders, congestive heart failure, and diabetes. Eligibility is determined by whether you have a chronic condition associated with the benefit(s). Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility.