This official government

booklet will help you

answer these questions:

• What diabetes supplies and 

services does Medicare help

pay for?

• Where can I get more 

information?

Medicare Coverage 

of Diabetes 

Supplies & Services
This booklet explains your benefits in the Original Medicare Plan. It isn’t a legal

document.The official Medicare provisions are contained in relevant laws, 

regulations, and rulings.
Introduction

This booklet explains Medicare coverage of diabetes

supplies and services in the Original Medicare Plan,

also known as “fee-for-service.” If you are in a

Medicare Advantage Plan (formerly called 

Medicare + Choice), your plan must give you at

least the same coverage as the Original Medicare

Plan, but it might have different rules. Your costs,

rights, protections, and choices for where you get

your care might be different if you are in one of

these plans. You might also get extra benefits. 

Read your plan materials or call your benefits 

administrator for more information.

For more information about Medicare, get a free

copy of the Medicare & You handbook (CMS Pub.

No. 10050). Look on page 23 to see how to get this

handbook.

This booklet doesn’t have detailed information

about the tests you should get and what you can do

to help control your diabetes. To learn more about

these things, talk with your doctor, diabetes 

educator, or other health care provider. They are 

there to help you. You should also talk with your 

doctor about your treatment options. You and your 

doctor can decide what’s best for you.
Table of Contents

Medicare Basics ..............................................................................................1–2

Covered Supplies ..........................................................................................3–7

Blood sugar self-testing equipment and supplies ................................................3–5

Therapeutic shoes ..............................................................................................6–7

Insulin pumps and related supplies ........................................................................7

Covered Services..........................................................................................8–14

Diabetes self-management training ..................................................................8–10

Medical nutrition therapy services ........................................................................11

Foot care ..............................................................................................................12

Hemoglobin A1c tests ..........................................................................................12

Special eye exams..................................................................................................13

Medicare Part B-covered preventive services ........................................................13

Glaucoma testing........................................................................................13

Flu and pneumococcal shots ......................................................................13

Diabetes screening......................................................................................14

Supplies and Services that Aren’t Covered by Medicare ..............15

Medicare Rights and Protections..............................................................16

What is “Assignment” in the Original Medicare Plan

and Why is It Important? ............................................................................17

Getting More Information ....................................................................18–23

Free Booklets About Medicare and Related Topics ..............................................23

Words To Know ..........................................................................................24–25

(Where words in green are defined)
Medicare Basics

1

What is Medicare?

Medicare is a health insurance program for

• people age 65 or older,

• people under age 65 with certain disabilities, and

• people of all ages with End-Stage Renal Disease (permanent kidney 

failure requiring dialysis or a kidney transplant).

Medicare has

Part A (Hospital Insurance)

Most people don’t pay a premium for Part A because they or a spouse already

paid for it through their payroll taxes while working. Medicare Part A helps

cover your inpatient care in hospitals, including critical access hospitals, and

skilled nursing facilities. It also helps cover hospice care and some home

health care. You must meet certain conditions to get these benefits.

Part B (Medical Insurance) 

Most people pay a monthly premium for Part B. Medicare Part B helps

cover your doctors’ services and outpatient hospital care. It also covers some

other medical services that Part A doesn’t cover, such as some of the services

of physical and occupational therapists, and some home health care. Part B

helps pay for these covered services and supplies when they are medically

necessary.

Medicare Health Plans

Your health plan choices include

• the Original Medicare Plan - available nationwide.

OR

• Medicare Advantage Plans - available in many areas. 

The Medicare health plan you choose affects many things, such as 

out-of-pocket costs (such as any deductibles you must pay before getting

some benefits), benefits (some have extra benefits such as coverage for extra

days in the hospital), choice of doctors and providers, convenience, and

quality.

Words in green

are defined on

pages 24–25.
Medicare Basics

2

Medicare Health Plans (continued)

If you join a Medicare Advantage Plan

• you are still in the Medicare program.

• you must have Medicare Part A and Part B, and continue to pay 

the monthly premium (the Medicare Part B premium is $78.20 in 

2005). This amount will increase each year. If you are already in a 

Medicare Managed Care Plan and have only Part B, you may stay in 

your plan.

• you still get all your regular Medicare-covered services. You may 

be able to get extra benefits such as coverage for extra days in the

hospital.

• you have Medicare rights to protect you (see page 16).

For help comparing your health plan choices, use the “Medicare

Personal Plan Finder,” available at www.medicare.gov on the web. You

can also call 1-800-MEDICARE (1-800-633-4227) to get a Customer

Service Representative to help you. TTY users should call 

1-877-486-2048. You will get your Medicare Personal Plan Finder

results in the mail within three weeks. 

Remember! If you are in a Medicare Advantage Plan, your plan must

give you at least the same coverage as the Original Medicare Plan, but it

may have different rules. Your out-of-pocket costs, rights, protections,

and choices for where you get your care may be different if you are in

one of these plans. You may also get extra benefits. Read your plan

materials or call your benefits administrator for more information.

Note: If you have other insurance that supplements the Original

Medicare Plan, it may pay some of the costs for the services

described in this booklet. Contact your plan’s benefits administrator

for more information.
Diabetes Supplies

3

Covered Supplies 

Medicare covers certain supplies if you have diabetes and you have

Medicare Part B. These covered supplies include

• blood sugar (glucose) monitors (see below),

• therapeutic shoes (see page 6), and

• insulin pumps (see page 7).

Blood sugar self-testing equipment and supplies

Blood sugar (also called blood glucose) self-testing equipment and supplies

are covered for all people with Medicare who have diabetes. This includes

people who use insulin and people who don’t use insulin.

These supplies include

• blood sugar monitors,

• blood sugar test strips,

• lancet devices and lancets, and

• glucose control solutions for checking the accuracy of testing 

equipment and test strips.

Medicare currently covers the same type of blood sugar testing supplies for

people with diabetes whether or not they use insulin. However, the amount

of supplies that are covered varies. If you use insulin, you may be able to get 

• up to 100 test strips and lancets every month, and 

• one lancet device every six months. 

If you don’t use insulin, you may be able to get

• 100 test strips and lancets every three months, and 

• one lancet device every six months. 

If your doctor says it is medically necessary, Medicare will allow additional

test strips and lancets.

For more information about diabetes supplies, call 1-800-MEDICARE 

(1-800-633-4227) and get the telephone number for your Durable Medical

Words in Equipment Regional Carrier. TTY users should call 1-877-486-2048. green

are defined on

pages 24–25.
4

Diabetes Supplies

Blood sugar self-testing equipment and supplies (continued)

How do I get these covered supplies? 

To get your Medicare-covered blood sugar self-testing equipment and supplies, you

need a prescription from your doctor. The prescription should include the 

following information:

• That you have diabetes

• What kind of blood sugar monitor you need and why you need it (If you 

need a special monitor because of vision problems, your doctor must also 

explain why you need this special monitor.)

• Whether you use insulin

• How often you should test your blood sugar

• How many test strips and lancets you need for one month

Keep in mind that

• you can order and pick up your supplies at your pharmacy.

• you can order your supplies from a medical equipment supplier. If you get 

your supplies this way, you must place the order yourself. You will probably 

need a prescription from your doctor to place your order, but your doctor can’t 

order it for you. 

• you must ask for refills for your supplies.

• you need a new prescription from your doctor for your lancets and test 

strips every 12 months.

Note: Medicare won’t pay for any supplies you didn’t ask for, or for any supplies that

were sent to you automatically from suppliers, including blood sugar monitors, 

test strips, and lancets. If you think you are getting too many supplies sent to you

automatically, are getting advertisements that are misleading, or suspect fraud 

relating to your diabetes supplies, call 1-800-MEDICARE (1-800-633-4227) and get

the telephone number for your Durable Medical Equipment Regional Carrier.

TTY users should call 1-877-486-2048.

You must get supplies from a pharmacy or supplier that is enrolled in Medicare. 

If you go to a pharmacy or supplier that isn’t enrolled in Medicare, Medicare won’t

pay. You will have to pay the entire bill for any supplies from non-enrolled 

pharmacies or non-enrolled suppliers.
Bloodsugar self-testing equipmentand supplies (continued)

How do I get these covered supplies? (continued)

All Medicare-enrolled pharmacies and suppliers must submit claims for glucose

monitor test strips. You can’t submit a claim for glucose monitor test strips 

yourself. You should also make sure that the pharmacy or supplier accepts 

assignment for Medicare-covered supplies. This could save you money. If the

pharmacy or supplier accepts assignment, Medicare will pay the pharmacy or 

supplier directly. You should only pay your coinsurance amount when you get

your supply from a pharmacy or supplier for assigned claims. 

If your pharmacy or supplier doesn’t accept assignment, charges may be 

higher, and you may pay more. You may also have to pay the entire charge at 

the time of service, and wait for Medicare to send you its share of the cost.

Remember: Before you get a supply from a supplier or pharmacy, ask

• are you enrolled in Medicare?

• do you accept assignment?

If the answer to either of these two questions is “no,” you may want to call

another supplier or pharmacy in your area. Ask them the same questions. 

By finding a supplier or pharmacy that answers “yes” to both questions, you

could save money. If you can’t find a supplier or pharmacy in your area that is

enrolled in Medicare and accepts assignment, you may want to order your 

supplies through the mail. This could also save you money.

For more information about assignment, get a free copy of Does your doctor or

supplier accept assignment? (CMS Pub. No. 10134). Look on page 23 to see

how to get this booklet.

What are the costs for these covered supplies?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Medicare Part B deductible ($110 in 2005). 

The deductible amount will change each year.

Diabetes Supplies

5

Words in green

are defined on

pages 24–25.
Diabetes Supplies

6

Therapeutic Shoes

If you have Medicare Part B, have diabetes, and meet certain conditions

(see below), Medicare will cover therapeutic shoes if you need them.

The types of shoes that are covered each year are

• one pair of depth-inlay shoes and three pairs of inserts, or

• one pair of custom-molded shoes (including inserts) if you can’t 

wear depth-inlay shoes because of a foot deformity, and two 

additional pairs of inserts.

Note: In certain cases, Medicare may also cover separate inserts or shoe

modifications instead of inserts.

How do I get therapeutic shoes?

In order for Medicare to pay for your therapeutic shoes, the doctor

treating your diabetes must certify that you meet all of the following

three conditions:

1. Have diabetes

2. Have at least one of the following conditions in one or both feet:

• partial or complete foot amputation

• past foot ulcers

• calluses that could lead to foot ulcers

• nerve damage because of diabetes with signs of problems with 

calluses

• poor circulation

• deformed foot

3. Are being treated under a comprehensive diabetes care plan and need

therapeutic shoes and/or inserts because of diabetes

Medicare also requires that

• a podiatrist or other qualified doctor prescribe the shoes, and

• a doctor or other qualified individual like a pedorthist, orthotist, 

or prosthetist fit and provide the shoes.
Diabetes Supplies

7

Therapeutic Shoes (continued)

What are the costs for therapeutic shoes?

There are limits to the amount that Medicare will pay. In the Original

Medicare Plan, you pay 20% of the Medicare-approved amount after the

yearly Medicare Part B deductible ($110 in 2005). This amount can be

higher if your provider or supplier doesn’t accept assignment, and you

may have to pay the entire amount at the time of service. Medicare will

then send you its share of the cost.

Note: The deductible amount will change each year. 

Insulin pumps and related supplies

Insulin pumps worn outside the body (external), including the insulin

used with the pump, may be covered for some people with Medicare

who have diabetes and who meet certain conditions. 

How do I get an insulin pump?

If you need to use an insulin pump, your doctor will prescribe this for you.

What are the costs for an insulin pump? 

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). Medicare will

pay for the insulin pump. Medicare will also pay for the insulin that is

used with the insulin pump.

Note: The deductible amount will change each year.

For more information about durable medical equipment and diabetes

supplies, call 1-800-MEDICARE (1-800-633-4227) and get the 

telephone number for your Durable Medical Equipment Regional

Carrier. TTY users should call 1-877-486-2048.

Words in green

are defined on

pages 24–25.
8

Diabetes Services

Covered Services 

For all people with Medicare, Medicare covers screenings to check for 

diabetes beginning January 1, 2005. See page 14 for more information.

For people with diabetes, Medicare covers certain services. Your doctor

must write an order or referral for you to get these services. Once your

doctor writes this order, you should get the services as soon as possible.

You need to make sure that you have your doctor’s written order before

you get the services. These services include

• diabetes self-management training (see below),

• medical nutrition therapy services (see page 11),

• hemoglobin A1c tests (see page 12),

• special eye exams (see page 13), and

• flu and pneumococcal shots (see page 13).

You can get some Medicare-covered services without a written order

or referral. These services include

• foot care (see page 12), and

• glaucoma testing (see page 13).

Diabetes self-management training

Diabetes self-management training helps you learn how to successfully 

manage your diabetes. Your doctor must prescribe this training for you for

Medicare to cover it.

You can get diabetes self-management training if, during the last 12-months 

• you’ve been recently diagnosed with diabetes,

• you’ve changed from taking no diabetes medication to taking 

diabetes medication, or from oral diabetes medication to insulin,

• you have diabetes and have recently become eligible for Medicare, or

• you’re at risk for complications from diabetes (see below). 

Your doctor may consider you at increased risk if 

• you’ve had problems controlling your blood sugar, have been 

treated in an emergency room or have stayed overnight in a 

hospital because of your diabetes,

• you’ve been diagnosed with eye disease related to diabetes,

• you’ve had a lack of feeling in your feet or some other foot 

problems like ulcers, deformities, or have had an amputation, or

• you’ve been diagnosed with kidney disease related to diabetes.

NEW —
9

Diabetes Services

Diabetes self-management training (continued)

Your doctor will usually give you information about where to get diabetes

self-management training. You must get this training from a certified diabetes

self-management education program under a plan of care prepared by your

doctor or qualified non-doctor practitioner. These programs are certified by

the American Diabetes Association or the Indian Health Service.

Classes are taught by health care providers who have special training in 

diabetes education. You are covered to get a total of 10 hours of initial 

training within a continuous 12-month period. One of the hours can be

given on a one-on-one basis. The other nine hours must be training in a

group class. The initial training must be completed no more than 12 months

from the time you start the training. 

Important: You may be able to get 10 hours of individual training if your

doctor prescribes it. Your doctor may prescribe individual training if you are

blind or deaf, have language limitations, or no group classes have been 

available within two months of your doctor’s order.

To be eligible for two more hours of follow-up training each year after the

year you received initial training, you must get another written order from

your doctor. The two hours of follow-up training can be with a group class or

you may have one-on-one sessions. Remember, your doctor must prescribe

this follow-up training each year for Medicare to cover it. 

Diabetes self-management training programs might not be available in all

areas. Check with the American Diabetes Association (see page 18) or the

Indian Health Service (see page 21) to find the certified training program

nearest you. If there isn’t a training program in your area, ask your doctor for

a referral to a registered dietitian to get the covered diabetes 

self-management training. 

Note: If a certified training program isn’t available in your area, call your

Medicare Administrative Contractor to find out where you can get this

training. You can get the telephone number for the Medicare Administrative

Contractor in your state by calling 1-800-MEDICARE (1-800-633-4227) or

going to www.medicare.gov on the web. Select “Helpful Contacts.”

Words in green

are defined on

pages 24–25.
10

Diabetes Services

Diabetes self-management training (continued)

What will I learn in this training?

You will learn how to successfully manage your diabetes. This will include

information on self-care and making lifestyle changes. The first session is an

individual assessment to help the instructors better understand your needs.

Classroom training will cover topics such as

• general information about diabetes, and the benefits and risks of 

blood sugar control,

• nutrition and how to manage your diet,

• options to manage and improve blood sugar control,

• exercise and why it is important to your health,

• how to take your medications properly,

• blood sugar testing and how to use the information to improve your

diabetes control,

• how to prevent, recognize, and treat acute and chronic complications 

from your diabetes,

• foot, skin, and dental care,

• how diet, exercise, and medication affect blood sugar,

• how to adjust emotionally to having diabetes,

• family involvement and support, and

• the use of the health care system and community resources.

How much do I pay for diabetes self-management training?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). The deductible

amount will change each year.

Words in green

are defined on

pages 24–25.
11

Diabetes Services

Medical nutrition therapy services

In addition to diabetes self-management training, medical nutrition 

therapy services are also covered for people with diabetes. To be eligible

for this service, your fasting blood sugar has to meet a certain criteria.

Also, your doctor must prescribe this service for you. 

These services can be given by a registered dietitian or certain nutrition

professionals. Services include

• an initial nutrition and lifestyle assessment,

• nutrition counseling (what foods to eat and how to follow an 

individualized diabetic meal plan),

• how to manage lifestyle factors that affect your diabetes, and

• follow-up visits to check on your progress in managing your diet. 

Medicare covers three hours of one-on-one medical nutrition therapy

services the first year you receive the service, and two hours each year after

that. If your doctor determines there is a change in your diagnosis or

medical condition that makes a change in your diet necessary, you may be

able to get additional hours of medical nutrition therapy services.

Remember, your doctor must prescribe medical nutrition therapy services

each year for Medicare to pay for the service.

How much do I pay for medical nutrition therapy services?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). The deductible

amount will change each year.

Words in green

are defined on

pages 24–25.
12

Diabetes Services

Foot care

Who is covered?

If you have diabetes-related nerve damage in either of your feet, Medicare

will cover one foot exam every six months by a podiatrist or other foot

care specialist, unless you have seen a foot care specialist for some other

foot problem during the past six months. Medicare may cover more 

frequent visits to a foot care specialist if you have had a non-traumatic

(not because of an injury) amputation of all or part of your foot or your

feet have changed in appearance that may indicate you have serious foot 

disease. Remember, you should be under the care of your primary care

physician or diabetes specialist when receiving foot care.

How much do I pay?

In the Original Medicare Plan, you may have to pay 20% of the

Medicare-approved amount after the yearly Part B deductible ($110 in

2005). The deductible amount will change each year.

Hemoglobin A1c tests 

A hemoglobin A1c test is a lab test ordered by your doctor. It measures how

well your blood sugar has been controlled over the past three months. 

Who is covered? 

Anyone with diabetes is covered for this test if it is ordered by your doctor.

How much do I pay? 

Medicare may cover this test when your doctor orders it. Call your

Medicare Administrative Contractor if you have a question about how

much you will have to pay. You can get the telephone number for your

Medicare Administrative Contractor by calling 1-800-MEDICARE 

(1-800-633-4227) or going to www.medicare.gov on the web. Select

“Helpful Contacts.”

Words in green

are defined on

pages 24–25.
13

Diabetes Services

Special eye exams

Who is covered?

People with Medicare who have diabetes can get eye exams to check for

diabetic eye disease (called a dilated eye exam). Your doctor will decide how

often you need this exam.

How much do I pay?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). The deductible

amount will change each year.

Medicare Part B-covered preventive services

Medicare Part B covers certain preventive services for people with

Medicare. Some of these services are important for people with diabetes.

These services include

Glaucoma testing

Medicare will pay for you to have your eyes checked for glaucoma once

every 12 months. This test must be done or supervised by an eye 

doctor who is legally allowed to give this service in your state. 

How much do I pay?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). The deductible

amount will change each year.

Flu and pneumococcal shots (vaccinations) 

Medicare will pay for you to get a flu shot once a flu season in the fall or

winter. Medicare will also pay for you to get a pneumococcal shot. 

One pneumococcal shot may be all you ever need. Ask your doctor. 

How much do I pay?

In the Original Medicare Plan, you pay nothing for flu and pneumococcal

shots if your doctor accepts assignment (see page 17).

Words in green

are defined on

pages 24–25.
14

Diabetes Services

Medicare Part B-covered preventive services (continued)

Diabetes screening

Beginning January 1, 2005, Medicare will pay for you to get diabetes 

screening tests if you are at risk for diabetes. These tests are used to detect

diabetes early. Some, but not all, of the conditions that may qualify you as

being at risk for diabetes include

• high blood pressure,

• dyslipidemia (history of abnormal cholesterol and triglyceride levels),

• obesity (with certain conditions),

• impaired glucose tolerance, or

• high fasting glucose.

Medicare will pay for you to get two diabetes screening tests in a 12-month

period. After the initial diabetes screening test, your doctor will determine

when to do the second test. Diabetes screening tests that are covered include

the following:

• Fasting plasma glucose tests

• Other tests (and changes to those tests) approved by Medicare as 

appropriate

If you think you may be at risk for diabetes, talk with your doctor to see if

you can get diabetes screening tests that Medicare will cover.

How much do I pay?

In the Original Medicare Plan, you pay 20% of the Medicare-approved

amount after the yearly Part B deductible ($110 in 2005). The deductible

amount will change each year.

Who do I call if I have questions about what Medicare

covers? 

You should call 1-800-MEDICARE (1-800-633-4227). TTY users should

call 1-877-486-2048.

Words in green

are defined on

pages 24–25.
Diabetes Services

15

Supplies and Services that Aren’t Covered 

by Medicare

The Original Medicare Plan doesn’t cover everything. Diabetes supplies and

services not covered by Medicare include

• alcohol swabs,

• eye exams for glasses (called refraction),

• gauze,

• injection devices (like jet injectors),

• insulin pens,

• insulin (unless used with an insulin pump),

• orthopedic shoes (shoes for people whose feet are impaired, 

but intact),

• outpatient prescription drugs,*

• routine or yearly physical exams,

• syringes, and

• weight loss programs.

* Medicare’s new prescription drug coverage will start on January 1, 2006.

This will include coverage for insulin and medical supplies associated

with the injection of insulin. Medicare-approved drug discount cards are

available now. For more information, get a free copy of the Medicare &

You handbook (CMS Pub. No. 10050). Look on page 23 to see how to

get this handbook.

Words in green

are defined on

pages 24–25.
Medicare Rights and Protections

16

If you have Medicare, you have certain guaranteed rights. One of these is

the right to a fair, efficient, and timely process for appealing decisions

about health care payment or services. Some of the reasons you may

appeal are when

• a service or item isn’t covered and you think it should be.

• a service or item is denied and you think it should be paid.

• you question the amount that Medicare paid.

Information on how to file an appeal is on the notice that explains what

Medicare pays (called the Medicare Summary Notice). If you decide to file

an appeal, ask your doctor or provider for any information that may help

your case. If you need help filing an appeal, call your State Health

Insurance Assistance Program.

In addition, you have rights to

• receive information,

• receive emergency room services,

• see doctors, specialists, and go to Medicare-certified hospitals,

• participate in treatment decisions,

• know your treatment choices,

• get information in a culturally competent manner in certain 

circumstances (for example, get information in languages other 

than English from Medicare, and its providers and contractors),

• file complaints,

• nondiscrimination, and

• have your personal and health information kept private.

You may have additional rights if you are in the hospital or a skilled 

nursing facility, or if your home health care ends.

For more information about your Medicare rights and protections, get a

free copy of the booklet Your Medicare Rights and Protections (CMS Pub.

Words in No. 10112). Look on page 23 to see how to get this booklet. green

are defined on

pages 24–25.
Assignment in the Original Medicare Plan

17

What is “Assignment” in the Original Medicare

Plan and Why is It Important?

Assignment is an agreement between people with Medicare, their doctors

and suppliers, and Medicare. The person with Medicare agrees to let the

doctor or supplier request direct payment from Medicare for covered Part B

services, equipment, and supplies. Doctors or suppliers who agree to (or

must by law) accept assignment from Medicare can’t try to collect more

than the proper Medicare deductible and coinsurance amounts from the

person with Medicare, their other insurance, or anyone else.

Participating Physician Directory 

The national Participating Physician Directory contains names, addresses,

and specialties of Medicare participating physicians who have agreed to

accept assignment on all Medicare claims. Seeing doctors who agree to

accept assignment can save you money. This only applies to the Original

Medicare Plan.

• Look at www.medicare.gov on the web and select “Participating

Physician Directory.” 

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 

1-877-486-2048.

Supplier Directory

The Medicare website has a Supplier Directory that has information about

Medicare-enrolled suppliers. This includes the names, addresses, telephone

numbers, and information on the specific type(s) of available supplies.

Using suppliers who participate in the Medicare program can save you

money because they must accept assignment. This only applies to the

Original Medicare Plan.

• Look at www.medicare.gov on the web and select “Supplier Directory.”

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 

1-877-486-2048. 
Getting More Information

18

More information is available to help you make health care choices and 

decisions that best meet your needs. Some free booklets can be ordered, and

some information is on the web. If you don’t have a computer, your local

library or senior center may be able to help you find the information on their

computers.

American Association of Diabetes Educators (AADE)

AADE is an organization of health care professionals nationwide who provide

diabetes education and care. You can see a listing of diabetes educators in your

area. 

www.aadenet.org 

1-800-338-3633

American Association of Diabetes Educators

100 West Monroe Street

Suite 400

Chicago, IL 60603

American Diabetes Association (ADA)

The mission of the American Diabetes Association is to prevent and cure 

diabetes, and improve the lives of all people with diabetes. The ADA provides

information and other services to people with diabetes, their families, health

care professionals, and the public. You can subscribe to the monthly consumer

magazine (Diabetes Forecast), order diabetes education booklets, find training

programs, find support groups, and find tips on managing diabetes.

www.diabetes.org 

1-800-DIABETES (1-800-342-2383)

American Diabetes Association

Attn: National Call Center

1701 North Beauregard Street

Alexandria, VA 22311
Getting More Information

19

American Dietetic Association (ADA)

The American Dietetic Association can help you find a dietitian in your area

by using a ZIP code search. There are also a number of fact sheets available

to read or print from your computer.

www.eatright.org

1-800-877-1600

American Dietetic Association

120 South Riverside Plaza 

Suite 2000

Chicago, IL 60606-6995

Centers for Disease Control and Prevention (CDC),

Department of Health and Human Services (DHHS)

The Centers for Disease Control and Prevention has a special diabetes 

division, Division of Diabetes Translation, whose work is to help others use

research findings to improve diabetes care. The CDC also has state-based

diabetes control programs. On this website, you can find answers to

frequently asked questions about diabetes, information about diabetes

programs in your state, publications you can order or download, and the

National Diabetes Education Program (NDEP).

www.cdc.gov/diabetes/index.htm 

1-877-232-3422

(Inquiries and Publications)

CDC Division of Diabetes Translation

PO Box 8728

Silver Spring, MD 20910
Getting More Information

20

Diabetes Exercise and Sports Association (DESA)

The Diabetes Exercise and Sports Association’s purpose is to improve the

quality of life for people with diabetes through exercise. The DESA provides

pamphlets on diabetes and exercise. The website has information on exercise

and nutrition, as well as upcoming DESA-sponsored events.

www.diabetes-exercise.org 

1-800-898-4322

Diabetes Exercise and Sports Association

8001 Montcastle Drive

Nashville, TN 37221

Food and Drug Administration (FDA), DHHS

The mission of the Food and Drug Administration is to promote and 

protect the public health by helping safe and effective drugs and medical

devices reach the market in a timely way and continuing to check products

for safety after they are in use. 

www.fda.gov/diabetes 

Healthfinder

The healthfinder website is run by the U.S. Department of Health and

Human Services. It offers consumer information from the Federal

Government and its many partners. Healthfinder can link you to selected

online publications, clearinghouses, databases, websites, and support and

self-help groups, as well as government agencies and not-for-profit 

organizations that produce reliable information for the public.

www.healthfinder.gov 
Getting More Information

21

Indian Health Service (IHS)

The Indian Health Service National Diabetes Program develops, documents,

and sustains a public health effort to prevent and control diabetes in

American Indian and Alaskan Native peoples.

www.ihs.gov/medicalprograms/diabetes 

1-505-248-4182

Indian Health Service

Attn: IHS National Diabetes Program

5300 Homestead Rd NE

Albuquerque, NM 87110

Juvenile Diabetes Research Foundation

International (JDRF)

Juvenile Diabetes Research Foundation International supports diabetes

research to find a cure for Type 1 diabetes through fundraising events such as

the “Walk to Cure Diabetes,” galas, golf tournaments, and other community

activities. On their website, you will find information on JDRF chapters in

your area, a subscription to their monthly electronic research newsletter, a

subscription to their quarterly Countdown magazine, and books.

www.jdrf.org 

1-800-533-CURE (1-800-533-2873)

Juvenile Diabetes Research Foundation International

120 Wall Street

New York, NY 10005-4001
Getting More Information

22

National Diabetes Education Program (NDEP)

The National Diabetes Education Program is an education program 

developed by a partnership of the National Institutes of Health, Centers

for Disease Control and Prevention, and more than 200 public and private

organizations. The website has information on how to control diabetes, an

events calendar, as well as diabetes information in Spanish and Asian. 

www.ndep.nih.gov 

1-800-438-5383

National Diabetes Education Program

One Diabetes Way

Bethesda, MD 20814-9692

National Institute of Diabetes & Digestive &

Kidney Diseases (NIDDK) of the National

Institutes of Health (NIH), DHHS

The National Institute of Diabetes & Digestive & Kidney Diseases supports

clinical and basic research on diabetes. They also run a clearinghouse that

provides free information on all reading levels, and can answer your 

questions (by phone, fax, mail, or e-mail) and provide diabetes reference

materials.

www.niddk.nih.gov 

www.niddk.nih.gov/health/diabetes/ndic.htm (Clearinghouse)

1-800-860-8747 (Clearinghouse)

National Diabetes Information Clearinghouse

1 Information Way

Bethesda, MD 20892-3560
Getting More Information

23

Free Booklets About Medicare and Related

Topics

Medicare tries to give you information to help you make good health care

decisions. You can look at or order free booklets from Medicare to learn

more about the topics that are of interest to you. We are always adding new

booklets with detailed information about important subjects.

How do I get these booklets?

1. Look at www.medicare.gov on the web and select “Publications.” You can

read, print, or order some booklets. This is the fastest way to get a copy.

2. Call 1-800-MEDICARE (1-800-633-4227). Follow the instructions to

get a publication. TTY users should call 1-877-486-2048. You will get

your copy within three weeks.

3. Put your name on the web mailing list to get an e-mail message every

time a new booklet is available. To sign up, go to www.medicare.gov

and select “Mailing List” at the top of the page. 

Many booklets are available in English, Spanish, Audiotape (English and

Spanish), Braille, and Large Print (English and Spanish). Look at

www.medicare.gov for a list of available Medicare publications. 

Note: Some booklets might not be available in print, but all of the most

up-to-date versions are available at www.medicare.gov on the web. If you

don’t have a computer, your local library or senior center may be able to

help you find these publications.
Words To Know

24

Assignment: In the Original Medicare Plan,

this means a doctor agrees to accept Medicare’s

fee as full payment. If you are in the Original

Medicare Plan, it can save you money if your

doctor accepts assignment. You still pay your

share of the cost of the doctor’s visit. 

Coinsurance: The percent of the Medicareapproved amount that you have to pay after you

pay the deductible for Part A and/or Part B. 

In the Original Medicare Plan, the coinsurance

payment is a percentage of the approved amount

for the service (like 20%).

Deductible: The amount you must pay for

health care, before Medicare begins to pay, either

each benefit period for Part A, or each year for

Part B. These amounts can change every year.

Durable Medical Equipment: Medical

equipment that is ordered by a doctor for use in

the home. These items must be reusable, such as

walkers, wheelchairs, or hospital beds. DME is

paid for under Medicare Part B and Part A for

home health services.

Durable Medical Equipment

Regional Carrier: A private company that

contracts with Medicare to pay bills for durable

medical equipment.

Home Health Care: Skilled nursing care

and certain other health care you get in your

home for the treatment of an illness or injury. 

Hospice Care: A special way of caring for

people who are terminally ill, and for their 

family. This care includes physical care and

counseling. Hospice care is covered under

Medicare Part A (Hospital Insurance).

Managed Care Plan: In most managed

care plans, you can only go to doctors, 

specialists, or hospitals on the plan’s list except

in an emergency. Plans must cover all Medicare

Part A and Part B health care. Some managed

care plans cover extra benefits, like extra days in

the hospital. In most cases, it is a type of

Medicare Advantage Plan that is available in

some areas of the country. Your costs may be

lower than in the Original Medicare Plan.

Medicaid: A joint Federal and State program

that helps with medical costs for some people

with low incomes and limited resources.

Medicaid programs vary from state to state, but

most health care costs are covered if you qualify

for both Medicare and Medicaid.

Medically Necessary: Services or supplies

that

• are proper and needed for the diagnosis or

treatment of your medical condition,

• are provided for the diagnosis, direct care, and

treatment of your medical condition,

• meet the standards of good medical practice in

the local area, and

• aren’t mainly for the convenience of you or

your doctor.
Words To Know

25

Medicare Administrative Contractor:

A private company that contracts with Medicare

to pay Part A and Part B bills.

Medicare Advantage Plan: A Medicare

program that gives you more choices among

health plans. Everyone who has Medicare 

Parts A and B is eligible, except those who have 

End-Stage Renal Disease (unless certain 

exceptions apply). Medicare Advantage Plans

used to be called Medicare + Choice Plans.

Medicare-approved Amount: In the

Original Medicare Plan, this is the Medicare 

payment amount for an item or service. This is

the amount a doctor or supplier is paid by

Medicare and you for a service or supply. It may

be less than the actual amount charged by a 

doctor or supplier. The approved amount is

sometimes called the “Approved Charge.”

Original Medicare Plan: A pay-per-visit

health plan that lets you go to any doctor,

hospital, or other health care supplier who

accepts Medicare and is accepting new Medicare

patients. You must pay the deductible. Medicare

pays its share of the Medicare-approved

amount, and you pay your share (coinsurance).

The Original Medicare Plan has two parts: 

Part A (Hospital Insurance) and Part B

(Medical Insurance). 

Premium: The periodic payment to

Medicare, an insurance company, or a health

care plan for health care coverage.

Preventive Services: Health care to keep

you healthy or to prevent illness. For example,

Pap tests, pelvic exams, yearly mammograms,

and flu shots.

State Health Insurance Assistance

Program: A State program that gets money

from the Federal Government to give free local

health insurance counseling to people with

Medicare.

Supplier: Generally, any company, person, or

agency that gives you a medical item or service,

like a wheelchair or walker.
U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, Maryland 21244-1850

Official Business

Penalty for Private Use, $300

Publication No. CMS-11022

Revised September 2004

• To get this booklet on Audiotape (English and Spanish), in Braille, or Spanish, call

1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

• ¿Necesita usted una copia en español? También está disponible en audiocasete y letra

grande. Llame gratis al 1-800-MEDICARE (1-800-633-4227). Las personas que

usan TTY deben llamar al 1-877-486-2048.

This publication was developed in cooperation

with the Maryland Association of Diabetes

Educators.