Have you ever wondered why insurance pays for some of the things you need to care for your diabetes but not others? The fact is that insurance coverage can be confusing because different plans provide different benefits, and coverage can change from year to year. For example, in the last few years Medicare Part B began to pay for blood glucose testing strips for everyone with diabetes, even if they do not take insulin. Insulin pumps and supplies now are covered by Medicare for people who meet very specific criteria.
When Medicare adds benefits or adjusts coverage, it is important to take note because even if you do not have Medicare, other insurance plans often use it as a guide. The following are some of the new benefits provided by Medicare Part B:
- Ten hours of initial diabetes self-management training and two hours per year of follow-up. The education programs must be recognized by the American Diabetes Association, and you will need a referral from your doctor or nurse practitioner.
- Three hours of initial medical nutrition therapy with a registered dietitian. Not all dietitians choose to become Medicare providers, so be sure to check before scheduling a visit.
- Dilated eye exams.
- Annual foot examinations by a podiatrist for people with neuropathy or loss of sensation in their feet. Therapeutic shoes also are covered for people with neuropathy or other specific foot problems from diabetes. One pair of shoes and three pairs of inserts are covered.
If you are not sure what your insurance company covers, you can find out from your benefits office, insurance company or case manager. If you have questions about Medicare call (800) 633-4227.
MEDICARE GUIDELINES
To receive your diabetes equipment and supplies under Medicare, you need a prescription from your health care provider. It should indicate that you have been diagnosed with diabetes and specify the following:
- How many test strips and lancets you need in a month
- What kind of meter you need. For example, if you need a special meter for vision problems, the doctor should say so
- Whether you use insulin
- How often you should test your blood glucose
