The way Medicare covers your insulin depends on how you take insulin.
Part D may cover insulin and related medical supplies used to inject insulin (syringes, gauze, and alcohol swabs) if you have a prescription from your doctor. Your drug plan should cover medications and supplies you need to treat your diabetes at home as long as they are on the plan’s formulary (its list of covered drugs).
Contact your plan to learn more about its cost and coverage rules for insulin and related supplies.
Part B may cover insulin that you use with an insulin pump. Insulin pumps, related supplies, and the insulin used with these pumps are covered as durable medical equipment (DME) if you meet Medicare’s coverage criteria.
Original Medicare covers DME at 80% of its approved amount, meaning that as long as you get insulin from a supplier who accepts Medicare assignment, you will be responsible for a 20% coinsurance charge. If you need more information about whether your pump and insulin are covered by Original Medicare, call 1-800-MEDICARE. If you have a Medicare Advantage Plan, call your plan to learn more about its costs and coverage requirements for insulin and insulin pumps.
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