Your Medicare Coverage

Is my test, item, or service covered?

Insulin

How often is it covered?

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

Medicare prescription drug coverage (Part D) may cover these:

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

If you use an external insulin pump, insulin and the pump may be covered as durable medical equipment (DME). However, suppliers of insulin pumps might not provide insulin. For more information, see durable medical equipment.

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 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

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