Quick Answer
Medicare covers most diabetes supplies under Part B (as durable medical equipment) and insulin under Part D. Part B covers glucose monitors, test strips, lancets, and insulin pumps. Part D covers insulin, oral medications, and non-insulin injectables. The $35/month insulin cap applies to Part D-covered insulin.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Part B (DME) | Glucose Monitors, Test Strips, Insulin Pumps | 80% after Part B deductible; must use Medicare-enrolled supplier |
| Part D | Insulin, Oral Meds, Non-Insulin Injectables | $35/month insulin cap; $2,000 OOP cap (2025+) |
| Preventive Services (Part B) | Screenings, DSMT, MNT | $0 copay for most preventive services |
| Medicare Advantage | All of the Above + Extra Benefits | May include OTC supplies, gym membership, meal delivery |
Understanding Your Coverage Options
Part B: Durable Medical Equipment for Diabetes
Medicare Part B covers diabetes-related durable medical equipment (DME) when prescribed by a doctor and obtained from a Medicare-enrolled supplier. You pay 20% coinsurance after the Part B deductible ($257 in 2026).
What It Covers
- Blood glucose monitors (one every 5 years for most beneficiaries)
- Test strips: up to 100/month (non-insulin users) or 300/month (insulin users)
- Lancets and lancing devices
- Insulin pumps and pump supplies (when medically necessary)
- Continuous glucose monitors (CGMs) - covered since 2023
- Therapeutic shoes and inserts for diabetic foot disease
What It Doesn't Cover
- Does not cover insulin administered by injection pen (covered by Part D)
- Does not cover non-enrolled DME suppliers - must use Medicare-approved supplier
- Does not cover over-the-counter test strips or lancets without a prescription
Part D: Insulin and Oral Diabetes Medications
Medicare Part D covers insulin, oral diabetes medications (e.g., metformin, glipizide), and non-insulin injectables (e.g., GLP-1 agonists like semaglutide when prescribed for diabetes). The Inflation Reduction Act capped insulin costs at $35/month per covered insulin under Part D starting in 2023.
The Part D out-of-pocket cap of $2,000 (effective 2025) also benefits diabetic beneficiaries who take expensive medications.
What It Covers
- Insulin: $35/month cap per covered insulin (IRA, 2023)
- Oral medications: metformin, sulfonylureas, DPP-4 inhibitors, SGLT-2 inhibitors
- Non-insulin injectables: GLP-1 agonists (when prescribed for diabetes)
- 2026 Part D OOP cap: $2,000/year
- Coverage varies by plan formulary - check your plan's drug list
What It Doesn't Cover
- Does not cover GLP-1 drugs (e.g., Ozempic) prescribed solely for weight loss
- Does not cover insulin pump supplies under Part D (those are Part B)
- Does not cover brand-name drugs at the same cost as generics
Preventive Services for Diabetes
Medicare Part B covers several diabetes preventive services at no cost to you (no deductible, no coinsurance) when provided by a Medicare-enrolled provider.
What It Covers
- Diabetes screening tests: up to 2/year if at risk
- Diabetes self-management training (DSMT): 10 hours initial + 2 hours/year follow-up
- Medical nutrition therapy (MNT): 3 hours first year + 2 hours/year follow-up
- Annual wellness visit: includes diabetes risk assessment
- Glaucoma screening: annually for high-risk (diabetes is a risk factor)
What It Doesn't Cover
- Does not cover diabetes education if provider is not Medicare-certified
- Does not cover nutritional supplements or meal replacement products
- Does not cover routine foot care unless medically necessary
Diabetic Shoes and Foot Care
Medicare Part B covers one pair of therapeutic shoes (or one pair of depth-inlay shoes) plus up to three pairs of inserts per calendar year for beneficiaries with diabetic foot disease. A podiatrist or other qualified provider must certify medical necessity, and the shoes must be obtained from a Medicare-enrolled supplier.
What It Covers
- 1 pair of therapeutic/depth-inlay shoes per year
- Up to 3 pairs of inserts per year
- Requires doctor certification of diabetic foot disease
- Must use Medicare-enrolled shoe supplier
- You pay 20% coinsurance after Part B deductible
What It Doesn't Cover
- Does not cover shoes or inserts for cosmetic purposes
- Does not cover more than one pair of therapeutic shoes per calendar year
- Does not cover foot care for non-diabetic conditions under this benefit
Medicare Advantage and Extra Diabetes Benefits
Many Medicare Advantage plans offer extra benefits for diabetic beneficiaries beyond what Original Medicare covers. These may include over-the-counter (OTC) allowances for diabetes supplies, gym memberships (for weight management), meal delivery after hospitalization, and disease management programs.
Chronic Condition Special Needs Plans (C-SNPs) are designed specifically for beneficiaries with diabetes and may offer enhanced drug coverage and care coordination.
What It Covers
- OTC allowance for diabetes supplies (e.g., test strips, lancets)
- Disease management programs for diabetes
- C-SNPs (Chronic Condition SNPs) for diabetic beneficiaries
- Gym membership / fitness benefits for weight management
- Meal delivery after hospitalization
What It Doesn't Cover
- Does not guarantee C-SNP enrollment - must have qualifying chronic condition
- Extra benefits vary by plan and county - not available in all areas
- Does not cover services outside the plan's network without prior authorization
2026 Medicare Diabetes Coverage: What You Pay
| Service/Supply | Medicare Part | Medicare Pays | You Pay | Notes |
|---|---|---|---|---|
| Glucose monitor | Part B (DME) | 80% | 20% after $257 deductible | 1 every 5 years; must use enrolled supplier |
| Test strips (insulin user) | Part B (DME) | 80% | 20% after deductible | Up to 300/month |
| Insulin pump | Part B (DME) | 80% | 20% after deductible | Medically necessary; pump insulin also Part B |
| CGM (continuous glucose monitor) | Part B (DME) | 80% | 20% after deductible | Covered since 2023 |
| Insulin (vials/pens) | Part D | Varies by plan | $35/month cap per insulin | IRA cap; check formulary |
| Oral diabetes meds | Part D | Varies by plan | Copay/coinsurance per tier | $2,000 OOP cap (2025+) |
| Diabetes screening | Part B (Preventive) | 100% | $0 | Up to 2/year if at risk |
| DSMT (self-management training) | Part B (Preventive) | 100% | $0 | 10 hrs initial + 2 hrs/year |
| Therapeutic shoes | Part B (DME) | 80% | 20% after deductible | 1 pair + 3 inserts/year |
✦ Important Exceptions and Notes
CGM Coverage Expanded in 2023
CMS expanded coverage for continuous glucose monitors (CGMs) in 2023, removing the requirement that beneficiaries be insulin-dependent. All Medicare beneficiaries with diabetes who have a prescription for a CGM are now eligible.
Insulin Pump Insulin is Covered under Part B
If you use an insulin pump, the insulin used in the pump is covered under Part B (not Part D) as part of the DME benefit. This means the $35/month Part D cap does not apply - but Medicare pays 80% after the Part B deductible.
GLP-1 Agonists for Weight Loss are not Covered
GLP-1 agonists like semaglutide (Ozempic, Wegovy) are covered by Part D when prescribed for diabetes, but Medicare does not cover them when prescribed solely for weight loss.
Must Use Medicare-Enrolled Suppliers for DME
To receive Medicare coverage for glucose monitors, test strips, and other DME, you must obtain them from a Medicare-enrolled supplier. Purchasing from a retail pharmacy or non-enrolled supplier means Medicare will not pay.
✦ Recent Legislative and Regulatory Updates
$35/Month Insulin Cap (IRA, 2023)
PassedThe Inflation Reduction Act capped Part D insulin costs at $35/month per covered insulin starting in 2023. This applies to all Part D plans and Medicare Advantage plans with drug coverage.
CGM Coverage Expanded (2023)
PassedCMS removed the insulin-dependency requirement for CGM coverage under Part B, making CGMs available to all Medicare beneficiaries with diabetes who have a prescription.
Part D OOP Cap: $2,000 (IRA, 2025)
PassedThe $2,000 annual Part D out-of-pocket cap (effective 2025) benefits diabetic beneficiaries who take expensive medications like SGLT-2 inhibitors or GLP-1 agonists.
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed Medicare expert who helps beneficiaries understand their Medicare options.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent dedicated to helping those eligible for Medicare find the best coverage options.