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 guide has 

important information about:

• What’s covered

• Helpful tips to keep you healthy

• Where to get more information

Medicare Coverage of 

Diabetes Supplies & 

Services
Notice of 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 auxiliary aids and services, like publications, documents and 

communications, in Braille, large print, data/audio CD, relay services and TTY communications.

CMS provides free auxiliary aids and services to help us better communicate with people with disabilities. 

Auxiliary aids include materials in Braille, audio/data CD or other accessible formats.

Note: You can get the “Medicare & You” handbook electronically in standard print, large print, or as an eBook.

For Medicare publications, call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.

For all other CMS publications and documents, you can contact our Customer Accessibility Resource Staff:

Call 1-844-ALT-FORM (1-844-258-3676). TTY: 1-844-716-3676.

Send a fax to 1-844-530-3676.

Send an email to altformatrequest@cms.hhs.gov.

Send a letter to:

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

You can also contact the Customer Accessibility Resource staff:

• To follow up on a previous accessibility request

• If you have questions about the quality or timeliness of your previous request

Note: Your request for a CMS publication or document should include:

• Your name, phone number, and the mailing address where we should send the publications or documents.

• The publication title and CMS Product No., if known.

• The format you need, like Braille, large print, or data/audio CD.

Note: If you’re enrolled in a Medicare Advantage or Prescription Drug Plan, you can contact your plan to 

request their documents in an accessible format.

Nondiscrimination Notice

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.

How to file a complaint

If you believe you’ve been subjected to discrimination in a CMS program or activity, there are 3 ways to file a 

complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

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

2. By phone: Call 1-800-368-1019. TDD user 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
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 Services 17

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

Diabetes self-management training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Medical nutrition therapy services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Foot exams & treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Hemoglobin A1c tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Glaucoma tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Flu and pneumococcal shots (vaccinations) . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

“Welcome to Medicare” preventive visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Yearly “Wellness” visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Supplies & services that aren’t covered by Medicare . . . . . . . . . . . . . . . . . . . . . 23

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 call your benefits 

administrator for more information about your benefits.

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

booklet:

Coinsurance: This is 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: This is 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. Assignment is an agreement by 

your doctor, provider, or supplier to be paid directly by Medicare, to accept the 

payment amount Medicare approves for the service, and not to bill you for any 

more than the Medicare deductible and coinsurance. 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.
6 Section 1: Medicare Coverage for Diabetes At-a-Glance

Supply/service What’s covered What you pay

Anti-diabetic 

drugs

See page 16.

Medicare 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.

Medicare 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

Diabetes selfmanagement 

training (DSMT)

See pages 18–20.

Part B covers diabetes self-management 

training (DSMT) services for people 

recently diagnosed with diabetes or at 

risk for complications from diabetes. 

DSMT will teach you how to manage 

your diabetes. For Medicare to cover 

DSMT services, your doctor or other 

health care provider must order it and the 

DSMT services must be provided by an 

accredited individual or program.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Diabetes 

equipment & 

supplies

See page 10.

Part B covers home blood sugar (glucose) 

monitors and supplies used with the 

equipment, including blood sugar test 

strips, lancet devices, and lancets. There 

may be limits on how much or how often 

you get these supplies.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Diabetes supplies

See page 16.

Part D covers certain medical supplies to 

administer insulin (like 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 22.

Flu shot—To help prevent influenza or flu 

virus. This is normally covered only once 

a flu season in the fall or winter. You need 

a flu shot for the current virus each year. 

Medicare Part B covers this shot.

Pneumococcal shot—To help prevent 

pneumococcal infections (like certain 

types of pneumonia). Part B covers this 

shot.

No coinsurance, copayment, or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

Foot exams & 

treatment

See page 21.

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 22.

Part B covers this test once every 12 

months for people at high risk for 

glaucoma. You’re considered high risk for 

glaucoma if you have diabetes, or a family 

history of glaucoma, or are AfricanAmerican and 50 or older, or are Hispanic 

and 65 or older. 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.

Medicare 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.

Medicare Part B covers external durable 

insulin pumps and the insulin that 

the device uses under durable medical 

equipment if you meet certain conditions.

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

Medical nutrition 

therapy (MNT) 

services 

See page 21.

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. The doctor who 

treats your diabetes must certify your 

need for therapeutic shoes or inserts. The 

shoes and inserts must be prescribed by 

a podiatrist or other qualified health care 

provider and provided by a podiatrist, 

orthotist, prosthetist, or pedorthist. 

20% of the Medicare-approved 

amount after the yearly Part B 

deductible

“Welcome to 

Medicare” 

preventive visit 

See page 22.

Part B covers a one-time review of your 

health, and education and counseling 

about preventive services, including 

certain screenings, shots, and referrals for 

other care, if needed.

Note: You must have the visit within the 

first 12 months you have Part B. 

No copayment, coinsurance, or 

Part B deductible if your doctor 

or health care provider accepts 

assignment

Yearly “Wellness” 

visit

See page 23.

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 10–13.

• 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 you use insulin, you may be able to get up to 300 test strips and 300 lancets 

every 3 months.

• If you don’t use insulin, you may be able to get 100 test strips and 100 lancets 

every 3 months.

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) and 

related supplies approved for use in place of blood sugar monitors for making 

diabetes treatment decisions (like, changes in diet and insulin dosage). 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 durable 

medical equipment. 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 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.

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 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

Blood sugar self-testing equipment & supplies (continued) 

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 (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 (DME) (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 DME 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. For information about Medicare drug coverage, visit 

Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). 

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

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 

Supplies used when you inject or inhale insulin may be covered for people with 

Medicare Part D who have diabetes. These medical supplies include:

• Syringes

• Needles

• Alcohol swabs

• Gauze

• Inhaled insulin devices

For more information 

To get more information about Medicare drug coverage, you can:

• Visit Medicare.gov.

• 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 Services 4For people with diabetes, Medicare covers certain services. 

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

get these services. These services include:

• Diabetes screenings. See page 18.

• Diabetes self-management training (DSMT). See pages 18–20.

• Medical nutrition therapy services (MNT). See page 21.

• Hemoglobin A1c tests. See page 22.

You can get some Medicare-covered services without a written 

order or referral. These services include:

• Foot exams & treatment. See page 21.

• Glaucoma tests. See page 22.

• Flu & pneumococcal shots. See page 22.

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

Yearly “Wellness” visit). See pages 22–23. 
18 Section 4: Medicare-Covered Diabetes Services

Diabetes screenings 

Medicare 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.

Diabetes self-management training 

Diabetes self-management training (DSMT) helps you learn how to successfully 

manage your diabetes. Your doctor or other health care provider must prescribe this 

training for Medicare to cover it. 

You can get diabetes self-management training if you meet one of these conditions:

• You were diagnosed with diabetes.

• You changed from taking no diabetes medication to taking diabetes medication, or 

from oral diabetes medication to insulin.

• You have been diagnosed with diabetes and are at risk for complications (see 

below).

Your doctor or other health care provider may consider you at increased risk if any of 

these apply to you:

• You have 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 have a lack of feeling in your feet or some other foot problems, like ulcers, 

deformities, or have had an amputation.

• You’ve been diagnosed with kidney disease related to diabetes.
Section 4: Medicare-Covered Diabetes Services 19

Diabetes self-management training (continued) 

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

about where to get DSMT. You must get this training from an approved DSMT 

individual or program as part of a plan of care prepared by your doctor or other 

health care provider. These DSMT programs and individuals are accredited by 

the American Diabetes Association or the American Association of Diabetes 

Educators.

How much training is covered?

DSMT 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.

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, visit cms.hhs.gov/center/fghc.asp, or call 

1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
20 Section 4: Medicare-Covered Diabetes Services

Diabetes self-management training (continued) 

Telehealth: If you’re in a rural area, you may be able to get DSMT services from a 

practitioner, like a Registered Dietitian, in a different location through Telehealth. 

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

rural areas, so check with your DSMT professional to see if some of your DSMT 

services can be provided via Telehealth. For more information about Telehealth 

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

1-877-486-2048. 

What will I learn in this training?

Through DSMT, you’ll learn how to successfully manage your diabetes. This 

includes information on self-care and lifestyle changes. The first DSMT 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

• 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
Section 4: Medicare-Covered Diabetes Services 21

Medical nutrition therapy (MNT) services 

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

services are also covered 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:

• 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

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

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

nutrition therapy services each year for Medicare to pay for the MNT service.

Note: MNT 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, visit cms.hhs.gov/center/fqhc.asp, or call 

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

Teleheath: If you’re in a rural area, a registered dietitian or other nutritional 

professional in a different location may be able to provide MNT to you through 

Telehealth. Telehealth services are only available to patients at certain health care 

locations in rural areas, so check with your MNT provided to see if some of your 

MNT services can be provided via Telehealth. 

Foot exams & treatment 

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’ve seen a foot care specialist for some other foot problem during the 

past 6 months. Medicare may cover more frequent visits if you’ve had a nontraumatic (not because of an injury) amputation of all or part of your foot or your 

feet have changed in appearance which may indicate you have serious foot disease. 

Remember, you should be under the care of your primary care doctor or diabetes 

specialist when getting foot care. 
22 Section 4: Medicare-Covered Diabetes Services

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 if 

it’s ordered by your doctor.

For more information, call 1-800-MEDICARE (1-800-633-4227). TTY users can 

call 1-877-486-2048.

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. This test must be done or supervised by an eye 

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

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. 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.

Note: Medicare will cover this visit if you get it within the first 12 months you 

have Part B.
Section 4: Medicare-Covered Diabetes Services 23

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 cateract 

surgery

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

• Cosmetic surgery
24 Section 4: Medicare-Covered Diabetes Services

Notes
25

SECTION

Helpful Tips & 

Resources 5

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

You can order booklets at no cost to you, and look at 

information on the Internet. If you don’t have a computer, 

your local library or senior center may be able to help you 

find information.

For more information about diabetes, 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 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

Food and Drug Administration (FDA), HHS

 www.fda.gov/forpatients/illness/diabetes

Healthfinder

healthfinder.gov

Indian Health Service

ihs.gov/medicalprograms/diabetes

1-505-248-4182

Division of Diabetes Treatment & Prevention

5300 Homestead Road, NE

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

Phone numbers & websites (continued) 

National Diabetes Education Program (NDEP)

ndep.nih.gov

1-888-693-6337

National Diabetes Education Program

One Diabetes Way

Bethesda, Maryland 20814-9692

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

of the National Institutes of Health (NIH), DHHS

niddk.nih.gov

www.niddk.nih.gov/health-information/diabetes (Clearinghouse)

1-800-860-8747 (Clearinghouse)

National Diabetes Information Clearinghouse

1 Information Way

Bethesda, Maryland 20892-3560
Section 5: Helpful Tips & Resources 29

Notes
30 Section 5: Helpful Tips & Resources

Notes
Paid for by the Department of Health & Human Services.
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 August 2018

Medicare’s Coverage of Diabetes Supplies & Services

■ 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).