If you have diabetes, this

booklet is for you.

This booklet tells you...

• What diabetes supplies and services

Medicare helps pay for

• Where to go for more information

Medicare Coverage of Diabetes Supplies & Services
A note about the symbols used in this booklet:

means a mailing address.

means a telephone number.

means a number for TTY, text telephone for people with special

equipment.

means a computer website address.

If you do not have a computer, your local library or senior center may be able to

help you find information on their computers.









This booklet explains your benefits in the Original Medicare Plan. It is not a legal

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

regulations, and rulings.
Table of Contents

1

Introduction ........................................................................................................2

Medicare Basics ..................................................................................................3

Supplies Covered ..............................................................................................5

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

Therapeutic shoes ..................................................................................................8

Insulin pumps and related supplies ........................................................................9

Services Covered..............................................................................................10

Diabetes self-management training ......................................................................10

Medical nutrition therapy services ........................................................................13

Foot care ..............................................................................................................14

Hemoglobin A1c tests ..........................................................................................14

Special eye exams..................................................................................................15

Medicare Part B covered preventive services ........................................................15

Glaucoma screening ..................................................................................15

Flu and pneumoccocal pneumonia shots....................................................16

Supplies and services that are not covered by Medicare..............17

Medicare Rights and Protections..............................................................18

Help to Pay Your Health Care Costs ........................................................19

Medicare Savings Programs ..................................................................................19

Medicaid ..............................................................................................................20

Prescription Drug Assistance Programs ................................................................20

What is "assignment" in the Original Medicare Plan

and why is it important? ............................................................................21

Getting More Information ..........................................................................22

Durable Medical Equipment Regional Carriers ..................................27

Free Booklets About Medicare and Related Topics ..........................28

Words To Know ................................................................................................29

(Where words in green are defined)

Note: The telephone numbers listed on page 27 were correct at the time of printing.

Sometimes telephone numbers change. You can find the most up-to-date telephone

numbers by looking at www.medicare.gov on the web. Select “Helpful Contacts.” Or,

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

2

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 + Choice Plan (like an HMO), 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/or choices

of 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.

This booklet focuses on Medicare coverage for

people with diabetes. It is important to know how

you get your Medicare health care. You get all your

regular Medicare covered services under Part A

and Part B.

To learn more about Medicare, look at your copy of

the Medicare & You handbook (CMS Pub. No.

10050), which is mailed each fall to people with

Medicare. You can order a copy by calling 

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

should call 1-877-486-2048. You can also read or

print a copy of the handbook at www.medicare.gov

on the web. Select "Publications."

This booklet does not 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.
Medicare Basics

3

• People age 65 or older.

• Some people with disabilities under age 65.

• People with End-Stage Renal Disease (permanent kidney

failure requiring dialysis or a kidney transplant).

What is Medicare?

Medicare is a health insurance program for:

Medicare has Two Parts:

Part A, Hospital Insurance

Most people do not have to pay for Part A. Medicare Part A helps

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

skilled nursing facilities. It also covers hospice care and some

home health care. You must meet certain conditions.

Part B, Medical Insurance 

Most people pay monthly for Part B. Medicare Part B helps cover

your doctors' services, outpatient hospital care, and some other

medical services that Part A does not 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 + Choice Plans, including

• Medicare Managed Care Plans (like HMOs)

• Medicare Private Fee-for-Service Plans

These choices are available in many areas of the country. 

The way you get your Medicare health care affects many things,

like cost, doctor choice, benefits, convenience, and quality.

Words in green

are defined on

page 29.
Medicare Basics

4

If you join a Medicare Managed Care Plan or Medicare Private Feefor-Service Plan:

• You are still in the Medicare program.

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

monthly Medicare Part B premium ($54 in 2002). 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 like coverage for prescription drugs or

additional days in the hospital.

• You have Medicare rights to protect you (see page 18).

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), and select option

"0." A Customer Service Representative will help you. You will get your

Medicare Personal Plan Finder results in the mail within three weeks.

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

Remember! If you are in a Medicare + Choice Plan (like an HMO),

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

Medicare Plan, but it may have different rules. Your costs, rights, 

protections, and/or choices of 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.

Medicare Health Plans (continued)

  

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

5

Supplies Covered 

Medicare covers certain supplies if you have diabetes, and have

Medicare Part B. These covered supplies include:

• blood sugar (glucose) monitors (see below)

• therapeutic shoes (see page 8)

• insulin pumps (see page 9)

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

do not use insulin.

These 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 

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 6 months. 

If you do not use insulin, you may be able to get:

• 100 test strips and lancets every 3 months, and 

• one lancet device every 6 months. 

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

additional test strips and lancets.

For more information about diabetes supplies, call your Durable

Medical Equipment Regional Carrier (see page 27).

Words in green

are defined on

page 29.
6

Diabetes Supplies

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; and

• 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 cannot order it for you. 

• You must ask for refills for your supplies. Medicare will not pay for any supplies you did

not ask for, or for any supplies that were sent to you automatically from suppliers,

including blood sugar monitors, test strips, and lancets.

• You need a new prescription from your doctor for your lancets and test strips every twelve

months.

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

If you go to a pharmacy or supplier that is not enrolled in Medicare, Medicare will not pay.

You will have to pay the entire bill for any supplies.

All Medicare enrolled pharmacies and suppliers must submit claims for glucose monitor test

strips. You will no longer be able to submit a claim for glucose monitor test strips yourself. 

You should also make sure that the pharmacy or supplier accepts assignment for Medicarecovered supplies. This could save you money. If the pharmacy or supplier accepts

assignment, Medicare will reimburse 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 does not 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 charge.
Diabetes Supplies

7

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, call another supplier or

pharmacy in your area. Ask them the same questions. You want to try and

find a supplier or pharmacy that answers "yes" to both questions. This could

save you money. If no suppliers or pharmacies in your area are enrolled in

Medicare and accept 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). You can get this

booklet at www.medicare.gov on the web. Select "Publications." Or, call 

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

1-877-486-2048. See page 28 for more information.

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

amount after the yearly Medicare Part B deductible ($100 in 2002). 

Note: Make sure you go to a pharmacy or supplier that is enrolled in Medicare.

If you go to a pharmacy or supplier that is not enrolled, Medicare will not pay.

You will be responsible for paying the entire bill for any supplies. Also, all

Medicare enrolled pharmacies and suppliers must submit claims for glucose

monitor test strips. You will no longer be able to submit a claim for glucose

monitor test strips yourself. You should also make sure the pharmacy or

supplier accepts assignment for Medicare-covered supplies. This could save you

money.

What are the costs for these covered supplies?

  
Diabetes Supplies

8

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 cannot

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, your doctor

must certify that you meet 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; and

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, podorthist, or other qualified

doctor:

• Prescribe the shoes, and

• Fit or give you the shoes.
Diabetes Supplies

9

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 ($100 in 2002). 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 charge. 

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.

Words in green

are defined on

page 29.

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. Medicare will pay for the

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

the insulin pump.

For more information about durable medical equipment and diabetes

supplies, call your Durable Medical Equipment Regional Carrier

(see page 27).
10

Diabetes Services

Services Covered 

Medicare covers certain services if you have diabetes. 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 in hand before you get the services. These services include:

• Diabetes self-management training (see below)

• Medical nutrition therapy services (see page 13)

• Hemoglobin A1c tests (see page 14)

• Special eye exams (see page 15)

• Flu and pneumoccocal pneumonia shots (see page 16)

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

or referral. These services include:

• Foot care (see page 14)

• Glaucoma screening (see page 15)

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.

You can get diabetes self-management training if: 

• You are at risk for complications from diabetes (see below), or 

• You have been recently diagnosed with diabetes, or 

• You have diabetes and have recently become eligible for Medicare. 

Your doctor may consider you at increased risk if, during the last 12

months, you have: 

• Had problems controlling your blood sugar.

• Changed from taking no diabetes medications to taking diabetes

medication, or from oral diabetes medication to insulin.

• Been diagnosed with eye disease related to diabetes.

• Had a lack of feeling in your feet or some other foot problems like

ulcers, deformities, or have had an amputation.

• Been treated in an emergency room or have stayed overnight in a

hospital because of your diabetes.

• Been diagnosed with kidney disease related to diabetes.
11

Diabetes Services

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

self-management training. You must get this training from a Medicareapproved diabetes education program under a plan of care prepared by

your doctor or qualified non-doctor practitioner. Classes are taught by

health providers who have special training in diabetes education. You are

covered to get a total of 10 hours of initial training in 12 months. One of

the hours can be given on a one-on-one basis. The other 9 hours must be

training in a group class unless your doctor prescribes 10 hours of 

individual training for such conditions as blindness and deafness. The 

initial training must be completed 12 months from the time you start the 

training. 

To be eligible for 2 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 2 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 may not be available in all

areas. Check with the American Diabetes Association (see page 22) to find

the Medicare-approved 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 medical nutrition therapy benefit. 

Note: If a Medicare-approved training program isn’t available in your area,

you may be able to go to a training program in another area in your state.

Call your Medicare Carrier for more information. You can get the

telephone number for the Medicare Carrier in your state by calling

1-800-MEDICARE, or going to www.medicare.gov on the web. Select

“Helpful Contacts.”

Diabetes self-management training (continued)

 
12

Diabetes Services

How much do I pay for diabetes self-management

training?

In the Original Medicare Plan, you pay 20% of the Medicareapproved amount after the yearly Part B deductible ($100 in 2002).

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 trainers better understand

your needs. 

Classroom training will cover topics like:

• General information about diabetes and treatment 

• Nutrition and how to manage your diet

• Managing high and low blood sugar

• 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, find, and treat 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 

• The use of the health care system and community resources

What will I learn in this training? 

Words in green

are defined on

page 29.
13

Diabetes Services

These services can be given by a registered dietitian or nutrition

professional. Services include:

• An initial nutrition and lifestyle assessment,

• Nutrition counseling (what foods to eat),

• How to manage lifestyle factors that affect your diet, and

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

Medicare covers 3 hours of one-on-one medical nutrition therapy

services the first year you receive the service, and 2 hours each year

after that. If your condition, treatment, or diagnosis changes, 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 ($100 in 2002).

In addition to diabetes self-management training, medical

nutrition therapy services are also covered for people with

diabetes. Your doctor must prescribe this service for you. 

Medical nutrition therapy services

Words in green

are defined on

page 29.
14

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 6 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 6 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

($100 in 2002).

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 2 to 3

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 Carrier if you have a question about how much you will have

to pay. You can get the telephone number for the Medicare Carrier for

your state by calling 1-800-MEDICARE, or going to www.medicare.gov

on the web. Select “Helpful Contacts.” Words in green

are defined on

page 29.

 
15

Diabetes Services

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: 

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

every 12 months. This screening 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 ($100 in 2002).

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 Medicareapproved amount after the yearly Part B deductible ($100 in 2002).

Glaucoma screening
16

Diabetes Services

Medicare will pay for you to get a flu shot once a year. Flu

shots are available in the fall or winter. Medicare will also pay

for you to get a pneumoccocal pneumonia shot. One

pneumonia 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

pneumoccocal pneumonia shots if your doctor accepts

assignment (see page 21).

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

users should call 1-877-486-2048.

Medicare Part B Covered Preventive Services

(continued)

Flu and pneumoccocal pneumonia shots(vaccinations) 

Who do I call if I have questions about what

Medicare covers? 


Diabetes Services

17

Supplies and services that are not covered 

by Medicare

The Original Medicare Plan does not cover everything. Diabetes

supplies and services not covered by Medicare include:

• Prescription drugs

• Insulin pens

• Insulin (unless used with an insulin pump)

• Syringes

• Alcohol swabs

• Gauze

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

but intact)

• Eye exams for glasses (called refraction)

• Routine or yearly physical exams

• Weight loss programs

• Injection devices (like jet injectors)
Medicare Rights and Protections

18

If you have Medicare, you have certain guaranteed rights to help protect

you. One of these rights is the right to a fair, efficient, and timely

process for appealing decisions about health care payment or services.

You may appeal if:

• You don't agree with the amount that is paid.

• A service or item isn't covered and you think it should be 

covered.

• A service or item is stopped before you think it should be.

The instructions for filing an appeal are on the notice that explains

what Medicare pays (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 the State Health

Insurance Assistance Program in your state.

In addition to your appeal rights, you also have certain rights to:

• Information

• Get emergency services

• Go to any doctor, specialist, or Medicare-certified hospital

• Participate in treatment decisions

• Know your treatment choices

• Culturally competent services (for example, getting materials 

that are translated into a language you can understand)

• File complaints

• Nondiscrimination

• Privacy of personal information

• Privacy of health information

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 detailed information about your Medicare rights and

protections, you can get a free copy of the booklet Your Medicare Rights

and Protections (CMS Pub. No. 10112). To get a free copy, see page 28. 
Help to Pay Your Health Care Costs

19

There are other kinds of health coverage and programs that

may pay for some of your health care costs not covered by

Medicare. Some of these choices are listed below. 

1. Medicare Savings Programs

There are programs that help millions of people with Medicare save

money each year. States have programs for people with limited incomes

and resources that pay some or all of Medicare's premiums. Some

programs may also pay Medicare deductibles and coinsurance.

You can apply for these programs if:

• You have Medicare Part A. (If you pay for Medicare Part A but don't

think you can afford to, there is a program that may pay the

Medicare Part A premium for you); and

• You are an individual with resources of $4,000 or less, or are a couple 

with resources of $6,000 or less. Resources include money in a 

checking or savings account, stocks, or bonds; and

• You are an individual with a monthly income of less than $906, or

are a couple with a monthly income of less than $1,214. If you live 

in Hawaii or Alaska, income limits are slightly higher. Income limits 

will change slightly in 2003.

Note: If your income is less than the amounts listed above, you may

qualify for Medicaid (see page 20). For more information on Medicare

Savings Programs:

Call your State medical assistance office. Look in the blue pages section

of your local telephone directory for the telephone number. Or, call 

1-800-MEDICARE (1-800-633-4227) and ask for the telephone

number of your State medical assistance office. TTY users should call

1-877-486-2048.

Go to www.medicare.gov on the web and select "Helpful Contacts."

Select the state you want and select "Other Health Insurance

Programs." 






Help to Pay Your Health Care Costs

20

If your income and resources are even more limited than those

described under Medicare Savings Programs, you may qualify for

Medicaid. Most of your health care costs are covered if you have

Medicare and you qualify for Medicaid. Medicaid is a joint Federal and

state program that helps pay medical costs for some people with limited

incomes and resources. Medicaid programs vary from state to state.

People with Medicaid may also get coverage for nursing home care and

outpatient prescription drugs that are not covered by Medicare. 

To get more information on Medicaid:

Call your State medical assistance office. Look in the blue pages section

of your local telephone directory for the telephone number. Or, call 

1-800-MEDICARE (1-800-633-4227) and ask for the telephone

number of your State medical assistance office. TTY users should call

1-877-486-2048.

Go to www.medicare.gov on the web and select "Helpful Contacts."

Select the state you want, then select "Other Health Insurance Programs."

Or, go to www.cms.hhs.gov/medicaid to get general information about

Medicaid programs.

2. Medicaid





3. Prescription Drug Assistance Programs

There are programs that may offer you discounts or free medication. 

To get more information: 

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

call 1-877-486-2048. 

Go to www.medicare.gov on the web and select "Prescription Drug

Assistance Programs." If you don't have a computer, your local senior

center or library may be able to help you get this information.

For more information about these and other kinds of health coverage

and ways to pay health care costs, call 1-800-MEDICARE 

(1-800-633-4227). TTY users should call 1-877-486-2048. Ask for a

free copy of the Health Care Coverage Directory for People with Medicare

(CMS Pub. No. 02231). You can also read or print a copy of this

booklet at www.medicare.gov on the web. Select "Publications."



Words in green

are defined on

page 29.



 
Assignment in the Original Medicare Plan

21

What is "assignment" in the Original

Medicare Plan and why is it important?

Assignment is an agreement between Medicare, and doctors, other

health care providers, and suppliers of health care equipment and

supplies (like wheelchairs, oxygen, braces, and ostomy supplies).

Doctors, providers, and suppliers who agree to accept assignment

accept the Medicare-approved amount as payment in full for Part B

services and supplies. You pay the coinsurance and deductible

amounts. In some cases (such as if you have both Medicare and

Medicaid), your health care providers and suppliers must accept

assignment. 

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.

Go to 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 name, address,

telephone number, 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.

Go to 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

22

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 do not 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. Customer Service

1701 North Beauregard Street

Alexandria, VA 22311






Getting More Information

23

Centers for Disease Control and Prevention (CDC),

Department of Health & Human Services (DHHS)

The Centers for Disease Control and Prevention has a special diabetes

division, called 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

on 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







American Dietetic Association (ADtA)

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

216 W. Jackson Blvd.

Chicago, IL 60606-6995






Getting More Information

24

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

PO Box 1935

Litchfield Park, AZ 85340







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 &

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

25

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

and golf tournaments, and other community activities. On

their website, you will find information on JDRF chapters in

your area, a subscription to their electronic research newsletter,

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







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

languages.

www.ndep.nih.gov 

1-800-438-5383

National Diabetes Education Program

1 Diabetes Way

Bethesda, MD 20892-3600






Getting More Information

26

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 

For the clearinghouse, www.niddk.nih.gov/health/diabetes/ndic.htm

Clearinghouse 1-800-860-8747

National Diabetes Information Clearinghouse

1 Information Way

Bethesda, MD 20892-3560






Getting More Information

27

Durable Medical Equipment Regional Carrier (DMERC): Call about bills for durable

medical equipment and a list of approved suppliers of this equipment.

If you live in: Your DMERC is:

If you live in: Your DMERC is:

If you live in: Your DMERC is:

If you live in: Your DMERC is:

Illinois

Indiana

Maryland

Michigan

Minnesota

Ohio

Virginia

Washington D.C. West

Virginia

Wisconsin

Federal

1(800)270-2313

TTY: 

1(317)841-4677

Alaska

American Samoa

Arizona

California

Guam

Hawaii

Idaho

Iowa

Kansas

Missouri

Montana

Nebraska

Nevada

North Dakota

Northern Mariana

Islands

Oregon

South Dakota

Utah

Washington

Wyoming

Cigna Medicare

1(800)899-7095

TTY: 

1(800)970-7494

AdminaStar

This page has been intentionally left blank. It contains phone number

information. For the most recent phone number information, please

visit the Helpful Contacts section of our web site. Thank you.
Getting More Information

28

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.

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

can read, print, or order these booklets. This is the fastest way to get a

copy.

2. Call 1-800-MEDICARE (1-800-633-4227), and select option “4” to

order a free copy of the booklet you want. TTY users should call

1-877-486-2048. Have the publication number ready when you call.

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 bottom of the page. Then, select the

topic “Publications,” type your e-mail address in the box at the

bottom, and select “Subscribe.”

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

Spanish), Braille, and Large Print (English and Spanish). Some booklets

are also available in Chinese.

Look at www.medicare .gov on the web for a list of available Medicare

publications. 

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

up-to-date versions will be available at www.medicare.gov on the web.

Free Booklets About Medicare and Related

Topics

How do I get these booklets?
Words To Know

29

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. 

Durable Medical Equipment (DME):

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 (DMERC): 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: Hospice is 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).

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.

Medicare Managed Care Plan: These

are health care choices (like HMOs) in some

areas of the country. In most plans, you can

only go to doctors, specialists, or hospitals on

the plan's list. Plans must cover all Medicare

Part A and Part B health care. Some plans cover

extras, like prescription drugs. Your costs may

be lower than in the Original Medicare Plan.

Medicare Private Fee-for-Service

Plan: A private insurance plan that accepts

people with Medicare. You may go to any

Medicare-approved doctor or hospital that

accepts the plan’s payment. The insurance plan,

rather than the Medicare program, decides how

much it will pay and what you will pay for the

services you get. You may pay more for

Medicare-covered benefits. You may have extra

benefits the Original Medicare Plan does not

cover.

Original Medicare Plan: A pay-per-visit

health plan that lets you go to any doctor,

hospital, or other health care provider who

accepts Medicare. You must pay the deductible.

Medicare pays its share of the Medicareapproved amount, and you pay your share

(coinsurance). The Original Medicare Plan has

two parts: Part A (Hospital Insurance) and

Part B (Medical Insurance). 

Preventive Services: Health care to keep

you healthy or to prevent illness. For example,

Pap tests, pelvic exams, yearly mammograms,

and flu shots.

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

July 2002

• To get this booklet on Audiocassette (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 audio casete.

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

This publication was developed in cooperation

with the Maryland Association of Diabetes

Educators.