Page 58 - Appendices for Patti's Evaluation

7/21/2020 Insulin Coverage

Is my test, item, or service covered?

Insulin

Medicare Part B (Medical Insurance) doesn’t cover these:
Insulin (unless use of an insulin pump is medically necessary )

Insulin pens
Syringes

Needles
Alcohol swabs

Gauze

Your costs in Original Medicare

You pay 100% for insulin (unless used with an insulin pump, then you pay 20% of the Medicare-approved amount,
and the Part B deductible applies). You pay 100% for syringes and needles, unless you have Medicare prescription
drug coverage (Part D).

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider.
The specific amount you’ll owe may depend on several things, like:
Other insurance you may have

How much your doctor charges
Whether your doctor accepts assignment

The type of facility
Where you get your test, item, or service

Things to know

Part D may cover these:

Insulin
Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs

However, if you use an external insulin pump, insulin and the pump may be covered as durable medical equipment
(DME) under Part B. If you live in certain areas of the country, you may have to use specific pump suppliers for
Medicare to pay for an insulin pump.

Note

Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn’t cover -
like vision, hearing, or dental. Contact the plan for more information.

https://www.medicare.gov/coverage/insulin 1/2