Living with Diabetes

What Does It Cover?

Medicare Part B (medical insurance) provides coverage for:

• Doctors' services
• Outpatient hospital care
• Some medically necessary services not covered by Part A, including some physical and occupational therapy
• Services and some home health care

Part B also covers some diabetes-specific supplies and services, including:

• Blood glucose testing monitors
• Blood glucose test strips
• Lancet devices
• Lancets
• Glucose control solutions
• Medical nutrition therapy
• Diabetes self-management training
• Some beneficiaries may also qualify for coverage of therapeutic shoes

Additionally, Medicare Part B also covers some preventive care, including a "Welcome to Medicare" physical for new enrollees, diagnostic screenings for diabetes and cardiovascular disease, and glaucoma tests.

A one-time “Welcome to Medicare” physical exam is covered within the first 12 months of Part B coverage. Beginning January 1, 2011, Medicare Part B will also cover an “Annual Wellness Visit” which will include the creation (or update) of a personalized prevention plan and be available every 12 months after the first 12 months of Part B coverage or after receiving a Welcome to Medicare physical exam.

How Much Does It Cost?

• Unfortunately, Medicare Part B is not free. All Medicare enrollees who elect Part B coverage must pay a monthly premium. This premium can change from year to year. The Social Security Administration can verify the exact amount of your monthly premium. They can be reached at 1-800-772-1213.
• Additionally, if you enroll in Medicare Part B, you will have to meet a deductible first before Medicare will begin to pay its share. After that, Medicare will pay 80% of the Medicare-approved cost of your medically necessary supplies and services.  For some preventive services, the deductible and/or coinsurance will be waived.
• You do not have to enroll in Medicare Part B. However, if you decline to enroll when you are first eligible, and then decide to sign up later, you may have to pay extra for the coverage. Your monthly premium may increase by 10% for each 12 month period that you could have had Part B but did not sign up for it. You may have to pay this late enrollment penalty for as long as you have Part B, unless you meet certain conditions. Please call 1-800-MEDICARE (1-800-633-4227) for more information.

Medicare Competitive Bidding Program

The Medicare Competitive Bidding Program began on January 1, 2011, in 9 areas of the U.S, for certain items and supplies covered by Medicare. Under this program, a limited number of mail order suppliers were selected to provide mail order diabetes supplies to beneficiaries in these areas of the country. The Medicare Competitive Bidding Program impacts people residing in or visiting the following 9 areas:

Charlotte-Gastonia-Concord (North Carolina and South Carolina)
Cincinnati-Middletown (Ohio, Kentucky, and Indiana)
Cleveland-Elyria-Mentor (Ohio)
Dallas-Fort Worth-Arlington (Texas)
Kansas City (Missouri and Kansas)
Miami-Fort Lauderdale-Pompano Beach (Florida)
Orlando-Kissimmee (Florida)
Pittsburgh (Pennsylvania)
Riverside-San Bernardino-Ontario (California)

Click here for more information on the Medicare Competitive Bidding Program and a list of additional resources.