C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S

This official government booklet 

has important information about:

• What’s covered

• Helpful tips to keep you healthy

• Where to get more information

Medicare Coverage of 

Diabetes Supplies, Services, 

& Prevention Programs

3

Table of Contents

Introduction 4

Medicare Coverage for Diabetes At-a-Glance 5

Medicare Part B-Covered Diabetes Supplies 9

Blood sugar self-testing equipment & supplies . . . . . . . . . . . . . . . . . . . . . . . . . 10

Insulin pumps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Therapeutic shoes or inserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Replacing lost or damaged durable medical equipment or supplies 

 in a disaster or emergency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Medicare Part D Diabetes Coverage 15

Insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Anti-diabetic drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Diabetes supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

For more information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Medicare-Covered Diabetes Screenings & Services 17

Diabetes screenings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Medicare Diabetes Prevention Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Diabetes self-management training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Medical nutrition therapy (MNT) services . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Foot exams & treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Hemoglobin A1c tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Glaucoma tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Flu & pneumococcal shots (vaccinations) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

“Welcome to Medicare” preventive visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Yearly “Wellness” visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Supplies & services that aren’t covered by Medicare . . . . . . . . . . . . . . . . . . . . . 24

Helpful Tips & Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Tips to help control diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Phone numbers & websites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Section 1:

Section 2:

Section 3:

Section 4:

Section 5:

The information in this booklet describes the Medicare Program at the time this booklet was 

printed. Changes may occur after printing. Visit Medicare.gov, or call 1-800-MEDICARE 

(1-800-633-4227) to get the most current information. TTY users can call 1-877-486-2048.
4

Introduction

This booklet explains Medicare coverage of diabetes supplies and services in 

Original Medicare and with Medicare prescription drug coverage (Part D).

Original Medicare is fee-for-service coverage. The government usually pays your 

health care providers directly for your Medicare Part A (Hospital Insurance) 

and/or Part B (Medical Insurance) benefits.

If you have other insurance that supplements Original Medicare, like a Medicare 

Supplement Insurance (Medigap) policy, it may pay some of the costs for some of 

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

for more information.

If you have a Medicare Advantage Plan (like an HMO or PPO) or other Medicare 

health plan, your plan must give you at least the same coverage as Original 

Medicare, but it may have different rules. Your costs, rights, protections, and choices 

for where you get your care might be different if you’re in one of these plans. You 

might also get extra benefits. Read your plan materials, or contact your plan for 

more information.

It may be helpful to understand these terms as you read this 

booklet:

Coinsurance: An amount you may be required to pay as your share of the cost 

for services after you pay any deductibles. Coinsurance is usually a percentage (for 

example, 20%).

Copayment: An amount you may be required to pay as your share of the cost 

for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or 

prescription drug. A copayment is usually a set amount, rather than a percentage.

For example, you might pay $10 or $20 for a doctor’s visit or prescription.

Deductible: The amount you must pay for health care or prescriptions, before 

Original Medicare, your prescription drug plan, or your other insurance begins to 

pay.

Medicare-approved amount: In Original Medicare, this is the amount a doctor 

or supplier that accepts assignment can be paid. It may be less than the actual 

amount a doctor or supplier charges. Medicare pays part of this amount and you’re 

responsible for the difference.
5

SECTION

1

Medicare Coverage for 

Diabetes At-a-Glance 

T he chart on pages 6–8 provides a quick overview of some of the diabetes services and supplies 

covered by Medicare Part B (Medical Insurance) 

and Medicare Part D (prescription drug coverage). 

Generally, Part B covers the services that may affect 

people who have diabetes. Part B also covers some 

preventive services for people who are at risk for 

diabetes. You must have Part B to get services and 

supplies covered under Part B. Part D covers diabetes 

supplies used for injecting or inhaling insulin. You 

must be enrolled in a Medicare drug plan to get 

supplies covered under Part D.

You can also visit Medicare.gov/what-medicare-covers

to view the information in the chart.
6 Section 1: Medicare Coverage for Diabetes At-a-Glance

Supply/service What’s covered What you pay

Anti-diabetic drugs

See page 16.

Part D covers anti-diabetic drugs for 

maintaining blood sugar (glucose).

Coinsurance or 

copayment 

Part D deductible 

may also apply

Diabetes screenings

See page 18.

Part B covers these screenings if your doctor 

determines you’re at risk for diabetes. You 

may be eligible for up to 2 diabetes screenings 

each year.

No coinsurance, 

copayment, or Part 

B deductible for 

screenings 

Generally, 20% of the 

Medicare-approved 

amount after 

the yearly Part B 

deductible for

the doctor’s visit

Medicare Diabetes 

Prevention Program

See pages 18–19.

Part B covers a once-per-lifetime health 

behavior change program to help you 

prevent diabetes.

Nothing for these 

services if you’re 

eligible

Diabetes selfmanagement training

See pages 19–22.

Part B covers diabetes outpatient selfmanagement training to teach you to cope 

with and manage your diabetes. You must 

have diabetes and a written order from your 

doctor or other qualified health care provider 

who’s treating your diabetes.

20% of the 

Medicare-approved 

amount after 

the yearly Part B 

deductible

Diabetes equipment & 

supplies

See page 10.

Part B covers blood sugar or glucose testing 

monitors and infusion pumps, if necessary, 

to administer insulin and related supplies 

and accessories for this equipment, including 

test strips, lancets, glucose sensors, tubing, 

and insulin.

20% of the Medicareapproved amount 

after the yearly Part B 

deductible

Diabetes supplies

See page 16.

Part D covers certain medical supplies to 

administer insulin, including syringes, 

needles, alcohol swabs, gauze, and inhaled 

insulin devices.

Coinsurance or 

copayment

Part D deductible 

may also apply
Section 1: Medicare Coverage for Diabetes At-a-Glance 7

Supply/service What’s covered What you pay

Flu & pneumococcal 

shots 

See page 24.

Flu shot—To help prevent influenza 

or flu virus. Part B normally covers 

it only once a flu season in the fall 

or winter.

Pneumococcal shot—Part B 

covers this shot to help prevent 

pneumococcal infections (like 

certain types of pneumonia).

No coinsurance, copayment, or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

Foot exams & treatment

See page 23.

Part B covers a foot exam every 6 

months for people with diabetic 

peripheral neuropathy and loss of 

protective sensation, as long as they 

haven’t seen a foot care professional 

for another reason between visits.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Glaucoma tests

See page 23.

Part B covers this test once every 12 

months for people at high risk for 

glaucoma. Tests must be done by an 

eye doctor legally authorized by the 

state.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Insulin

See page 16.

Part D covers insulin that isn’t 

administered with an insulin pump.

Coinsurance or copayment

Part D deductible may also 

apply
8 Section 1: Medicare Coverage for Diabetes At-a-Glance

Supply/service What’s covered What you pay

Insulin pumps

See page 13.

Part B covers external durable 

insulin pumps and the insulin that 

the device uses under the durable 

medical equipment benefit if you 

meet certain conditions.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Medical nutrition 

therapy services 

See pages 22–23.

Part B may cover medical nutrition 

therapy (MNT) and certain related 

services if you have diabetes or 

kidney disease. Your doctor or 

other health care provider must 

refer you for the MNT services.

No copayment, coinsurance, or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

Therapeutic shoes or 

inserts

See page 13.

Part B covers therapeutic shoes or 

inserts for people with diabetes who 

have severe diabetic foot disease. 

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

“Welcome to Medicare” 

preventive visit See page 

24.

Within the first 12 months you have 

Part B, Medicare covers a onetime review of your health, and 

education and counseling about 

preventive services, including 

certain screenings, shots, and 

referrals for other care, if needed.

No copayment, coinsurance, or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

Yearly “Wellness” visit

See page 24.

If you’ve already had Part B for 

longer than 12 months, you can get 

a yearly “Wellness” visit to develop 

or update a personalized prevention 

plan based on your current health 

and risk factors.

No copayment, coinsurance or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

If you had a “Welcome to 

Medicare” visit, you’ll have to wait 

12 months before you can get your 

first yearly “Wellness” visit 
9

SECTION

Medicare Part B-Covered 

Diabetes Supplies 2

This section provides information about Medicare Part B (Medical Insurance) and its coverage of diabetes 

supplies. Medicare covers certain supplies if you have 

diabetes and you have Part B. These covered supplies 

include:

• Blood sugar self-testing equipment & supplies. 

See pages 10–12.

• Insulin pumps. See page 13.

• Therapeutic shoes or inserts. See pages 13–14.
10 Section 2: Medicare Part B-Covered Diabetes Supplies 

Blood sugar self-testing equipment & supplies

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

covered as durable medical equipment for all people with Medicare Part B who 

have diabetes, even if you don’t use insulin.

Self-testing supplies include:

• Blood sugar monitors

• Blood sugar test strips

• Lancet devices and lancets

• Glucose control solutions for checking the accuracy of testing equipment and 

test strips

Part B 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 your doctor says it’s medically necessary, Medicare will allow you to get 

additional test strips and lancets. “Medically necessary” means that services 

or supplies are needed for the diagnosis or treatment of your medical condition 

and meet accepted standards of medical practice. You may need to keep a 

record that shows how often you’re actually testing yourself.

Medicare also covers therapeutic continuous glucose monitors (CGMs) 

approved for use in place of blood sugar monitors for making diabetes 

treatment decisions (like, changes in diet and insulin dosage) and related 

supplies. If you use insulin and require frequent adjustments to your insulin 

regimen/dosage, a CGM may be covered if your doctor determines that you 

meet all of the requirements for Medicare coverage, including the need to 

frequently check your blood sugar (four or more times a day) and the need to 

either use an insulin pump or receive three or more insulin injections per day.

If you have questions about diabetes supplies, call 1-800-MEDICARE 

(1-800-633-4227). TTY users can call 1-877-486-2048.
Section 2: Medicare Part B-Covered Diabetes Supplies 11

Blood sugar self-testing equipment & supplies (continued)

What do I need from my doctor to get these covered supplies? 

Medicare will only cover your blood sugar self-testing equipment and supplies if you 

get a prescription from your doctor. The prescription should include:

• Whether 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 explain that.)

• Whether you use insulin.

• How often you should test your blood sugar.

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

Where can I get these supplies?

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

• You can order your supplies from a medical equipment supplier. Generally, a 

“supplier” is any company, person, or agency that gives you a medical item or 

service, except when you’re an inpatient in a hospital or skilled nursing facility.

If you get your supplies this way, you must place the order yourself. You’ll need a 

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

supplies for you.

Keep this in mind:

• 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’re getting 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). TTY users can call 

1-877-486-2048.

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

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

won’t pay. You’ll have to pay the entire bill for any supplies from non-enrolled 

pharmacies or non-enrolled suppliers.
12 Section 2: Medicare Part B-Covered Diabetes Supplies 

Blood sugar self-testing equipment & supplies (continued)

How are claims paid?

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

sugar (glucose) monitors, test strips, and other items covered under the durable 

medical equipment benefit. You can’t submit a claim for a blood sugar monitor or 

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 pay no more than your coinsurance amount when you get your supplies from 

a pharmacy or supplier that accepts assignment. 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.

What supplier or pharmacy should I use?

Before you get a supply it’s important to ask the supplier or pharmacy these 

questions:

• Are you enrolled in Medicare?

• Do you accept assignment?

If the answer to either of these 2 questions is “no,” you should call another supplier 

or pharmacy in your area who answers “yes” to be sure your purchase is covered 

by Medicare and to save you money.

If you can’t find a supplier or pharmacy in your area that’s enrolled in Medicare 

and accepts assignment, you may want to order your supplies through the mail.

This may also save you money.

To find a supplier that’s enrolled in Medicare, visit Medicare.gov/supplier. Or, call 

1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Section 2: Medicare Part B-Covered Diabetes Supplies 13

Insulin pumps 

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

with the pump, may be covered for some people with Medicare Part B who have 

diabetes and who meet certain conditions. Certain insulin pumps are considered 

durable medical equipment. “Durable medical equipment” is certain medical 

equipment ordered by your doctor for use in the home.

How do I get an insulin pump?

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

Note: In Original Medicare, you pay 20% of the Medicare-approved amount after 

the yearly Part B deductible. Medicare will pay 80% of the cost of the insulin and 

the insulin pump. For more information about durable medical equipment and 

diabetes supplies, visit Medicare.gov, or call 1-800-MEDICARE 

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

Therapeutic shoes or inserts 

If you have Part B, have diabetes, and meet certain conditions (see page 14), 

Medicare will cover therapeutic shoes if you need them.

The types of shoes that are covered each year include one of these:

• One pair of depth-inlay shoes and 3 pairs of inserts

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

depth-inlay shoes because of a foot deformity, and 2 additional pairs of inserts

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

modifications instead of inserts.
14 Section 2: Medicare Part B-Covered Diabetes Supplies

Therapeutic shoes or inserts (continued) 

How do I get therapeutic shoes?

For Medicare to pay for your therapeutic shoes, the doctor treating your diabetes 

must certify that you meet these 3 conditions:

1. You have diabetes.

2. You have at least one of these 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

• A deformed foot

3. You’re being treated under a comprehensive diabetes care plan and need 

therapeutic shoes and/or inserts because of diabetes.

Medicare also requires:

• A podiatrist or other qualified health care provider prescribes the shoes.

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

fits and provides the shoes.

Replacing lost or damaged durable medical equipment or 

supplies in a disaster or emergency

I have Original Medicare

If Original Medicare already paid for durable medical equipment (like a wheelchair 

or walker) or supplies (like diabetic supplies) damaged or lost due to an emergency 

or disaster:

• In certain cases, Medicare will cover the cost to repair or replace your equipment 

or supplies.

• Generally, Medicare will also cover the cost of rentals for items (like wheelchairs) 

during the time your equipment is being repaired.

Call 1-800-MEDICARE (1-800-633-4227) to get more information about how to 

replace your equipment or supplies. TTY users can call 1-877-486-2048.

I have a Medicare Advantage Plan or other Medicare health plan

Contact your plan directly to find out how it replaces durable medical equipment or 

supplies damaged or lost in an emergency or disaster.
15

SECTION

Medicare Part D 

Diabetes Coverage 3

T his section provides information about Medicare Part D (Medicare prescription drug coverage) for people 

with Medicare who have or are at risk for diabetes. To get 

Medicare drug coverage, you must join a Medicare drug plan. 

These diabetes drugs and supplies are covered under 

Medicare drug plans (on page 16):

• Insulin. 

• Anti-diabetic drugs. 

• Certain diabetes supplies. 
16 Section 3: Medicare Part D Diabetes Coverage

Insulin 

Medicare drug plans cover injectable insulin not used with an insulin infusion 

pump and inhaled insulin.

Anti-diabetic drugs 

Blood sugar (glucose) that isn’t controlled by insulin is maintained by anti-diabetic 

drugs. Medicare drug plans can cover anti-diabetic drugs like:

• Sulfonylureas (like Glipizide, and Glyburide)

• Biguanides (like metformin)

• Thiazolidinediones, like Actos® (Pioglitazone), Avandia® (Rosiglitazone), and 

Rezulin® (Troglitazone)

• Meglitinides, which are a class of anti-diabetic drug including Starlix® 

(Nateglinide) and Prandin® (Repaglinide)

• Alpha glucosidase inhibitors (like Precose®)

Diabetes supplies 

Medical supplies used when you inject or inhale insulin may be covered for 

people with Medicare Part D who have diabetes. These supplies include:

• Syringes

• Needles

• Alcohol swabs

• Gauze

• Inhaled insulin devices

For more information 

To get more information about Medicare drug coverage:

• Visit Medicare.gov/drug-coverage-part-d

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

1-877-486-2048.

• Call your State Health Insurance Assistance Program (SHIP). To get their 

phone number, visit shiptacenter.org, or call 1-800-MEDICARE.
17

SECTION

Medicare-Covered 

Diabetes Screenings 

& Services 4 Medicare Part B covers certain services , screenings, and 

trainings to help you prevent, detect, and treat diabetes. 

Medicare also covers certain preventive services to help you 

stay healthy. 

In general, your doctor must write an order or referral for you 

to get these services. These services include:

• Diabetes screenings. See page 18.

• Medicare Diabetes Prevention Program. See pages 18–19.

• Diabetes self-management training. See pages 19–22.

• Medical nutrition therapy services. See pages 22–23.

• Hemoglobin A1c tests. See page 23.

You can get some Medicare-covered services without a 

written order or referral. These services include:

• Foot exams & treatment. See page 23.

• Glaucoma tests. See page 23.

• Flu & pneumococcal shots. See page 24.

• Preventive visits (“Welcome to Medicare” preventive visit and 

Yearly “Wellness” visit). See page 24. 
18 Section 4: Medicare-Covered Diabetes Screenings & Services

Diabetes screenings 

Medicare Part B pays for diabetes screening tests if you’re at risk for diabetes.

These tests are used to detect diabetes early. You may be at risk for diabetes if 

you have:

• High blood pressure

• Dyslipidemia (history of abnormal cholesterol and triglyceride levels)

• Obesity (with certain conditions)

• Impaired glucose (blood sugar) tolerance

• High fasting glucose (blood sugar)

Medicare may pay for up to 2 diabetes screening tests in a 12-month period.

After the initial diabetes screening test, your doctor will determine if you need a 

second test. Medicare covers these diabetes screening tests:

• Fasting blood sugar tests

• Other 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 these tests.

Medicare Diabetes Prevention Program 

Medicare Part B covers a once-per-lifetime health behavior change program to 

help you prevent diabetes. The program begins with 16 core sessions offered in 

a group setting over a 6-month period. In these sessions, you’ll get:

• Training to make realistic, lasting behavior changes around diet and exercise 

• Tips on how to exercise more 

• Strategies to control your weight 

• A coach, specially trained to help keep you motivated 

• Support from people with similar goals and challenges

Once you complete the core sessions, you’ll get: 

• 6 more months of follow-up sessions to help you maintain healthy habits 

• An additional 12 months of ongoing maintenance sessions if you meet certain 

weight loss and attendance goals during the first year
Section 4: Medicare-Covered Diabetes Screenings & Services 19

Medicare Diabetes Prevention Program (continued) 

To be eligible, you must have: 

• Medicare Part B 

• A hemoglobin A1c test result between 5.7 and 6.4%, a fasting plasma glucose 

of 110-125mg/dL, or a 2-hour plasma glucose of 140-199 mg/dL (oral glucose 

tolerance test) within 12 months prior to attending the first core session 

• A body mass index (BMI) of 25 or more (BMI of 23 or more if you’re Asian) 

• Never been diagnosed with type 1 or type 2 diabetes 

• Not been currently diagnosed with End-Stage Renal Disease (ESRD)

• Never participated in the Medicare Diabetes Prevention Program 

You pay nothing for these services if you’re eligible.

Diabetes self-management training 

Medicare covers diabetes outpatient self-management training to teach you to 

cope with and manage your diabetes. The program may include tips for eating 

healthy, being active, monitoring blood sugar, taking medication, and reducing 

risks. You must have diabetes and a written order from your doctor or other 

qualified health care provider who’s treating your diabetes.
20 Section 4: Medicare-Covered Diabetes Screenings & Services

Diabetes self-management training (continued) 

Your doctor or other health care provider will usually give you information 

about where to get diabetes self-management training. You must get this training 

from an approved individual or program as part of a plan of care prepared by 

your doctor or other health care provider. These programs and individuals are 

accredited by a CMS-approved accreditation organization for diabetes selfmanagement training.

How much training is covered?

Diabetes self-management training classes are taught by health care professionals 

who have special training in diabetes education. You’re covered to get up to 10 

hours of initial training and 2 hours of follow-up training if you need it. 

The initial training must be completed no more than 12 months from the time you 

start it. The initial training includes one hour of training on an individual, one-onone basis. The other 9 hours of initial training are usually given in a group setting.

Important: Your doctor or other health care professional may prescribe up to 

10 hours of the initial training to be given to you on a one-on-one basis rather 

than in a group when it’s appropriate. Some indications for one-on-one training 

include if you have low-vision, a hearing impairment, a language or other 

communication difficulty, or have cognition limitations. In addition, if no groups 

are available within 2 months of the date of the order, one-on-one training is also 

covered.
Section 4: Medicare-Covered Diabetes Screenings & Services 21

Diabetes self-management training (continued) 

Up to 2 hours of follow-up training are covered each year after the year you 

receive the initial training if you need it. To be eligible for the follow-up training, 

you must get a written order from your doctor or other health care professional.

The follow-up training can be in a group or one-on-one sessions. Remember, 

your doctor or other health care professional must prescribe this follow-up 

training each year for Medicare to cover it.

Note: Diabetes self-management training is available in many Federally Qualified 

Health Centers (FQHCs). FQHCs provide primary health services and qualified 

preventive services in medically underserved rural and urban areas. Some types 

of FQHCs are Community Health Centers, Migrant Health Centers, Health 

Care for the Homeless Programs, Public Housing Primary Care Centers, and 

outpatient health programs/facilities operated by a tribe or tribal organization 

or by an urban Indian organization. No Part B deductible is applied. For more 

information about FQHCs, call 1-800-MEDICARE (1-800-633-4227). TTY users 

can call 1-877-486-2048.

Telehealth: If your health care provider is located in a rural area, you may be 

able to get diabetes self-management training services via telehealth from a 

practitioner, like a registered dietitian, who is in a different location. Telehealth 

services are only available to patients at certain types of health care locations in 

rural areas, so check with your practitioner to see if some of your training can 

be provided via telehealth. For more information about telehealth services, call 

1-800-MEDICARE (1-800-633-4227). 

What will I learn in this training?

Through diabetes self-management training, you’ll learn how to successfully 

manage your diabetes. This includes information on self-care and lifestyle 

changes. The first session is an individual assessment to help the instructors better 

understand your needs.

Classroom training will cover topics like these:

• General information about diabetes, the benefits of blood sugar control, and the 

risks of poor blood sugar control

• Nutrition and how to manage your diet

• Options to manage and improve blood sugar control
22 Section 4: Medicare-Covered Diabetes Screenings & Services

Diabetes self-management training (continued)

• Exercise and why it’s 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

• Behavior changes, goal setting, risk reduction, and problem solving

• How to adjust emotionally to having diabetes

• Family involvement and support

• The use of the health care system and community resources

Medical nutrition therapy services 

In addition to diabetes self-management training, medical nutrition therapy 

services are also covered by Medicare Part B for people with diabetes or renal 

disease. To be eligible for this service, your fasting blood sugar has to meet certain 

criteria. Also, your doctor or other health care provider must prescribe these 

services for you.

A registered dietitian or certain nutrition professionals can give these services:

• Nutrition counseling (what foods to eat and how to follow an individualized 

diabetic meal plan)

• How to manage lifestyle factors that affect your diabetes

Remember, your doctor or other health care provider must prescribe medical 

nutrition therapy services each year for Medicare to pay.
Section 4: Medicare-Covered Diabetes Screenings & Services 23

Medical nutrition therapy services (continued)

Note: Medical nutrition therapy is available in many Federally Qualified Health 

Centers (FQHCs). FQHCs provide primary health services and qualified 

preventive services in medically underserved rural and urban areas. Some types 

of FQHCs are Community Health Centers, Migrant Health Centers, Health 

Care for the Homeless Programs, Public Housing Primary Care Centers, and 

outpatient health programs/facilities operated by a tribe or tribal organization or 

by an urban Indian organization. No Part B deductible or coinsurance is applied.

For more information about FQHCs, call 1-800-MEDICARE (1-800-633-4227).

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

Teleheath: If your health care provider is located in a rural area, you may be able 

to get medical nutrition therapy services via telehealth from a practitioner, like a 

registered dietitian or other nutritional professional who is in a different location.

Telehealth services are only available to patients at certain types of health care 

locations in rural areas, so check with your provider to see if some of these 

services can be provided via telehealth.

Foot exams & treatment 

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

Part B will cover one foot exam every 6 months by a podiatrist or other foot care 

specialist, unless you’ve seen a foot care specialist for some other foot problem 

during the past 6 months. Remember, you should be under the care of your 

primary care doctor or diabetes specialist when getting foot care.

Hemoglobin A1c tests 

A hemoglobin A1c test is a lab test that measures how well your blood sugar has 

been controlled over the past 3 months. If you have diabetes, this test is covered 

by Part B if it’s ordered by your doctor.

Glaucoma tests 

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

every 12 months if you’re at risk. You’re considered high risk for glaucoma if you 

have diabetes, or a family history of glaucoma, or are African-American and 50 or 

older, or are Hispanic and 65 or older. This test must be done or supervised by an 

eye doctor who’s legally allowed to give this service in your state.
24 Section 4: Medicare-Covered Diabetes Screenings & Services

Flu & pneumococcal shots (vaccinations) 

Part B will pay for you to get a flu shot generally once a flu season in the fall or 

winter. Part B will also pay for a pneumococcal shot to prevent pneumococcal 

infections (like certain types of pneumonia). Part B covers a different second 

pneumococcal shot 11 months after you get the first shot. Talk with your doctor 

or other health care provider to see if you need these shots.

“Welcome to Medicare” preventive visit 

Part B covers a one-time review of your health, and education and counseling 

about preventive services within the first 12 months you have Part B. This 

includes information about certain screenings, shots, and referrals for other care 

if needed. The “Welcome to Medicare” preventive visit is a good opportunity to 

talk with your doctor about the preventive services you may need, like diabetes 

screening tests.

Yearly “Wellness” visit 

If you’ve had Medicare Part B for longer than 12 months, you can get a yearly 

“Wellness” visit to develop or update a personalized prevention plan based on 

your current health and risk factors. This includes:

• A review of medical and family history

• A list of current providers and prescription drugs

• Your height, weight, blood pressure, and other routine measurements

• A screening schedule for appropriate preventive services

• A list of risk factors and treatment options for you

Supplies & services that aren’t covered by Medicare 

Original Medicare and Medicare drug plans don’t cover everything. For example, 

these supplies and services aren’t covered:

• Eyeglasses and exams for glasses (called refraction), except after cataract 

surgery

• Orthopedic shoes (shoes for people whose feet are impaired, but intact)

• Cosmetic surgery
25

SECTION

Helpful Tips & 

Resources 5

More information is available to help you make health care choices and decisions that meet your needs. 

For more information about Medicare coverage of 

diabetes supplies and services, visit Medicare.gov or call 

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

1-877-486-2048.
26 Section 5: Helpful Tips & Resources

Tips to help control diabetes 

You can do many things to help control your diabetes. Here are some tips that can 

help you stay healthy:

Eat right

• Talk with your doctor about what you eat, how much you eat, and when you 

eat. Your doctor, diabetes educator, or other health care provider can develop a 

healthy eating plan that’s right for you.

• Talk with your doctor about how much you should weigh. Your doctor can talk 

to you about the different ways to help you reach your weight goal.

Take medicine as directed

• Talk with your doctor if you have any problems.

Exercise

• Be active for a total of 30 minutes most days. Talk with your doctor about 

which activities can help you stay active.

Check these things

• Check your blood sugar (glucose) as often as your doctor tells you. You should 

record this information in a record book. Show your records to your doctor.

• Check your feet for cuts, blisters, sores, swelling, redness, or sore toenails. It’s 

very important to keep your feet healthy to prevent serious foot problems.

• Frequently check your blood pressure.

• Have your doctor check your cholesterol.

• If you smoke, talk with your doctor about how you can quit. Medicare will cover 

smoking cessation (counseling to stop smoking) if ordered by your doctor.

Using these tips can help you manage your diabetes. Talk with your doctor, 

diabetes educator, or other health care provider about your treatment, the tests 

you should get, and what you can do to help control your diabetes. You should 

also talk with your doctor about your treatment options. You and your doctor 

can decide what’s best for you. You can also find out more by contacting the 

organizations on the next 2 pages.
Section 5: Helpful Tips & Resources 27

Phone numbers & websites 

Centers for Disease Control and Prevention (CDC), 

Department of Health and Human Services (HHS) 

cdc.gov/diabetes

1-800-232-4636

(Inquiries and Publications)

CDC Division of Diabetes Translation

1600 Clifton Road

Atlanta, Georgia 30333

Healthfinder

healthfinder.gov

Indian Health Service

1-505-256-6716

Division of Diabetes Treatment & Prevention

4101 Indian School Road NE, Ste 225

Albuquerque, New Mexico 87110
28 Section 5: Helpful Tips & Resources

Phone numbers & websites (continued) 

National Diabetes Education Program (NDEP)

ndep.nih.gov

1-800-860-8747

National Diabetes Education Program

9000 Rockville Pike

Bethesda, Maryland 20892

National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) 

of the National Institutes of Health (NIH), DHHS

niddk.nih.gov

niddk.nih.gov/health-information/diabetes

1-800-860-8747 (Clearinghouse)
Section 5: Helpful Tips & Resources 29

Notes
30 Section 5: Helpful Tips & Resources

CMS Accessible Communications

To help ensure people with disabilities have an equal opportunity to participate in 

our services, activities, programs, and other benefits, we provide communications in 

accessible formats. The Centers for Medicare & Medicaid Services (CMS) provides free 

auxiliary aids and services, including information in accessible formats like Braille, 

large print, data/audio files, relay services and TTY communications. If you request 

information in an accessible format from CMS, you won’t be disadvantaged by any 

additional time necessary to provide it. This means you’ll get extra time to take any 

action if there’s a delay in fulfilling your request.

To request Medicare or Marketplace information in an accessible format you can:

1. Call us: For Medicare: 1-800-MEDICARE (1-800-633-4227) TTY: 1-877-486-2048.

2. Email us: altformatrequest@cms.hhs.gov.

3. Send us a fax: 1-844-530-3676.

4. Send us a letter:

Centers for Medicare & Medicaid Services

Offices of Hearings and Inquiries (OHI)

 7500 Security Boulevard, Mail Stop S1-13-25

Baltimore, MD 21244-1850

 Attn: Customer Accessibility Resource Staff

Your request should include your name, phone number, type of information you need 

(if known), and the mailing address where we should send the materials. We may 

contact you for additional information.

Note: If you’re enrolled in a Medicare Advantage Plan or Medicare Prescription Drug 

Plan, contact your plan to request its information in an accessible format. For Medicaid, 

contact your State or local Medicaid office.
Paid for by the Department of Health & Human Services.

Nondiscrimination Notice

The Centers for Medicare & Medicaid Services (CMS) doesn’t exclude, deny benefits 

to, or otherwise discriminate against any person on the basis of race, color, national 

origin, disability, sex, or age in admission to, participation in, or receipt of the services 

and benefits under any of its programs and activities, whether carried out by CMS 

directly or through a contractor or any other entity with which CMS arranges to carry 

out its programs and activities.

You can contact CMS in any of the ways included in this notice if you have any 

concerns about getting information in a format that you can use.

You may also file a complaint if you think you’ve been subjected to discrimination in 

a CMS program or activity, including experiencing issues with getting information 

in an accessible format from any Medicare Advantage Plan, Medicare Prescription 

Drug Plan, State or local Medicaid office, or Marketplace Qualified Health Plans.

There are three ways to file a complaint with the U.S. Department of Health and 

Human Services, Office for Civil Rights:

1. Online: hhs.gov/civil-rights/filing-a-complaint/index.html.

2. By phone: Call 1-800-368-1019. TTY users can call 1-800-537-7697.

3. In writing: Send information about your complaint to:

Office for Civil Rights

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201
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 

CMS Product No. 11022

Revised December 2019

Medicare’s Coverage of Diabetes Supplies, Services,

& Prevention Programs

■ Medicare.gov

■ 1-800-MEDICARE (1-800-633-4227) 

■ TTY: 1-877-486-2048 

¿ Necesita usted una copia en español? 

Llame GRATIS al 1-800-MEDICARE (1-800-633-4227).