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        Diabetes
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        What Is Diabetes?
                Symptoms & Causes
                Risk Factors for Type 2 Diabetes
                Preventing Type 2 Diabetes
                Diabetes Tests & Diagnosis
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                Insulin, Medicines, & Other Diabetes Treatments
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                Financial Help for Diabetes CareFinancial Help for Diabetes Care
**On this page:**
What health insurance plans cover people with diabetes?
    Local Resources for Care and Costs
    Help Paying for Diabetes Medicines and Supplies
    Help Paying for Prosthetic Care
    Help Paying for Kidney Dialysis and Transplantation
    Help for College Students with Diabetes
    Assistive Technology for Living with Diabetes
    Key TermsDiabetes management is expensive. According to the American Diabetes Association (ADA), the average cost of health care for a person with diabetes is $16,752 a year—more than twice the cost of health care for a person without diabetes.1
Many people who have diabetes need help paying for their care. You can find help through private or government health insurance, local programs, patient support groups, and medicine-assistance programs. You can also find ways to save money on diabetes medicines and supplies.
What health insurance plans cover people with diabetes?
Health insurance helps pay for medical care, including the cost of diabetes care. Your health insurance options are
private health insurance, which includes group and individual health insurance
    government health insurance, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), TRICARE, and veterans’ health care programsUnder current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition”—that is, a health problem you had before the date that new health coverage starts.
Changes to insurance rules happen often and may affect your health insurance choices. Learn more or get help with your health insurance questions through
HealthCare.gov , the federal marketplace, 1-800-318-2596, TTY: 1-855-889-4325
    the Center for Consumer Information & Insurance Oversight Program , which offers help by phone, by email, or at walk-in locations
    the state health insurance resources tool  of the American Diabetes Association
    the National Association of Insurance CommissionersLearn key terms about diabetes costs, insurance, and financial aid.
Compare coverage for diabetes care
When choosing a health insurance plan, ask about every service and supply you’ll need to manage your diabetes. Does the plan cover the medicines, supplies, and devices that you are using, and, if not, what are the alternatives? What does the plan pay? How much will you need to pay out of pocket? Consider
each prescription medicine you need
    diabetes supplies and devices, such as an insulin pump
    diabetes lab tests  and screening exams
    medical office visits, nutrition counseling, and specialists, such as eye doctors
    copayments and deductibles
    health care providers—do your providers participate in the plan, or will you have to change providers or pay more to see your current providers because they are out of network?Ask for a Summary of Benefits and Coverage, which explains the plan in plain language, including free preventive services. This summary may include a coverage example for managing diabetes.A couple reviewing paperwork and typing into a calculator.When looking for health insurance, determine if each plan pays for the services and supplies you need to manage your diabetes.Private health insurance
Insurance companies sell private health insurance plans. Two types of private health insurance are
**Group health insurance.** People buy this kind of health insurance through their employer, union, or a family member’s employer or union. Professional or alumni groups may also offer group health insurance, which may be helpful for people who are self-employed.
    **Individual health insurance.** People buy this coverage for themselves and their families.
    HealthCare.gov is one way to find, compare, and buy individual insurance plans in most states—or connect to your state’s insurance marketplace. HealthCare.gov also
        tells you whether you qualify for a premium tax credit  that lowers your monthly premiums and cost-sharing reductions  that lower your out-of-pocket costs. Only people who buy plans through HealthCare.gov or a state exchange can get premium tax credits or cost-sharing reductions.
            lists the yearly open enrollment period when you can choose or change your plan
            lists the life events that allow you to buy insurance any time of year
        Learn more about Healthcare.gov online  or by calling 1-800-318-2596, TTY: 1-855-889-4325.
        Insurance companies, agents, brokers, and online insurance stores are other ways to find and buy individual health insurance plans. Learn how to find a trustworthy insurance company at USA.gov  or by calling 1-844-USA-GOV1 (1-844-872-4681).Preventive  care
You may be eligible for some important preventative services  at no additional cost to you. These services can help find and treat health problems early. For example, adults who are overweight or who have obesityorhigh blood pressuremay be able to get diabetes screening tests at no out-of-pocket cost. Adults and children may be able to get obesity screening and weight-management counseling at no out-of-pocket cost.
Keeping health insurance after leaving a job
A federal law called COBRA allows you to stay on your employer’s health plan for 18 to 36 months after leaving a job. You’ll pay both your own monthly premiums and the employer’s portion, so your cost is likely to be higher than before.
People with a disability may be able to extend COBRA coverage for an extra 11 months.
    COBRA may also cover young adults who “age out” of a parent’s policy when they reach the age limit of 26.Learn more about COBRA online or call the U.S. Department of Labor at 1–866–4–USA–DOL (1–866–487–2365).
Federal Government health insurance
What is Medicare?
Medicare is a federal health insurance program that pays health care costs for eligible people who are
age 65 or older
    under age 65 with certain disabilities
    of any age with end-stage renal disease—total and permanent kidney failure that requires a kidney transplant or blood-filtering treatments called dialysisWhat health plans does Medicare offer?
**Medicare** has four parts:
**Part A**, or hospital insurance, covers hospital stays, skilled nursing homes, hospice care, and some home health care. Part A has no premium for those who have paid enough Medicare taxes. Part A has a deductible, which is an amount you pay for your care each year before the plan begins to pay.
    **Part B**, or medical insurance, covers doctor visits, outpatient care, some home health care, medical equipment including insulin pumps, and some preventive services. You pay a monthly premium based on your income. After you pay the deductible each year, Part B pays 80 percent for most covered services, and you pay 20 percent.
    Part B covers the Medicare Diabetes Prevention Program  (MDPP) for members with prediabetes. The MDPP provides healthy eating and physical activity training sessions and support over 12 months, which research shows can sharply lower diabetes risk.
    **Medicare Advantage Plans** are private insurance plans that combine Medicare Part A and B benefits with extras such as medicine coverage. The Federal Government sets the basic rules for Medicare Advantage plans. However, you’ll find many options for extra services, along with different premiums and copayments. Covered services  can change from year to year. Ask about
    whether you need a referral to see a specialist
        whether you must use doctors, clinics, or suppliers that belong to one plan, also called “in network” providers
    **Part D**, or prescription drug coverage, is optional coverage offered by private companies, with approval from Medicare. Your premiums, deductible, additional costs, and covered medicines depend on which Part D plan you choose. You may qualify for lower Part D premiums and lower medicine costs, depending on your income and resources. Learn more about the Medicare Extra Help Program online.**Other Medicare health plans** are available with special rules or for specific groups of people. Medicare offers more information online. These alternate health plans include
**Medicare Cost Plans,** which often include payments for out-of-network providers
    **Medicare Demonstrations and Pilot Projects,** which test improvements in Medicare coverage and care
    **Programs of All-Inclusive Care for the Elderly (PACE),** which combine medical, social, and long-term care services for frail people who live in the community
    **Medication Therapy Management Programs,** which can help you learn how to manage your medications if you’re in a Medicare drug planLearn more about benefits, rules, and coverage details at Medicare.gov  or by calling 1-800-MEDICARE (1-800-633-4227).
Which diabetes services and supplies does Medicare cover?
Medicare Part B and Part D cover many diabetes services and supplies. You may first need to pay a deductible, copayment, or coinsurance. Some services are free if your doctor orders them.
Medicare Part B helps pay for
diabetes screening tests for people at risk of developing diabetes
    diabetes self-management training
    diabetes supplies such as glucose monitors, test strips, and lancets
    certain continuous glucose monitors and supplies
    counseling to help people who have obesity lose weight
    eye exams to check for glaucoma and diabetic retinopathy
    flu and pneumonia shots
    foot exams and treatment for people with diabetes
    insulin pumps and insulin that will be used with an insulin pump
    medical nutrition therapy services for people with diabetes or kidney disease
    therapeutic shoes or insertsMedicare Part D helps pay for
diabetes medications
    diabetes supplies such as needles and syringes for injecting insulin
    insulin, except for insulin used with an insulin pump, which is covered by Medicare Part BCheck your own plan to learn exactly what is covered. Each plan, especially Medicare Advantage Plans, may offer different coverage for diabetes care. Read more about Medicare’s diabetes coverage rules (PDF, 671 KB)  online or call 1-800-MEDICARE (1-800-633-4227).
Diabetes supplies on a table, including a lancet, insulin syringe, glucose meter, and test strips.Medicare pays for many diabetes supplies and drugs under Part B and Part D, which is the optional, extra coverage for medicines.
What is Medigap?
Medigap plans help pay costs that are not covered by Medicare, such as deductibles, copayments, and coinsurance. You can buy a Medigap policy from a licensed insurance company in your home state. Learn more online about Medigap rules, benefits, deadlines, and premiums.
What other federal programs can help?
The following federal programs can provide more resources for people with diabetes
U.S. Department of Veterans Affairs
    TRICARE
    Indian Health Service
    Hill-Burton Free and Reduced-cost Health Care Program
    Bureau of Primary Health Care
    Social Security Administration
    Social Security Disability Insurance (SSDI)
    Supplemental Security Income (SSI)
    Women, Infants, and Children (WIC)The **Social Security Administration** can provide financial help through two programs
**SSDI** pays a monthly amount to people who can’t work and have paid enough Social Security taxes. If an illness or injury keeps you out of work for at least a year, SSDI payments may be an option.
    **SSI** pays a monthly amount to disabled children and adults who earn little and don’t have many financial assets. A person who gets SSI may be able to get Medicaid and food stamps  through the Supplemental Nutrition Assistance Program (SNAP), too.Read more about both SSDI and SSI and how to apply at ssa.gov or by calling 1–800–772–1213, TTY: 1–800–325–0778.
**WIC** serves mothers and children who are at risk for poor nutrition or hunger. This includes low-income women who are pregnant, breastfeeding, or recently had a baby, as well as infants and children up to age 5. Pregnant women who have gestational diabetes  may qualify for help through the WIC program. WIC provides
supplemental foods
    health care referrals
    nutrition education
    breastfeeding informationLearn more about WIC online,  or call the WIC’s headquarters at 703-305-2062.
State government health insurance
What  is Medicaid?
Medicaid is a health insurance program funded by the Federal Government and state governments for people with low incomes and few assets. Each state runs its own program based on federal rules. Some states cover more services than federal rules require. Many states expanded Medicaid in recent years to cover more people, including low-income adults without dependent children.
Find out whether you qualify for Medicaid in your state, or apply for coverage through
HealthCare.gov, 1-800-318-2596, TTY: 1-855-889-4325
    National Association of Medicaid Directors state agency locatorLearn more at Medicaid.gov  or call 1-877-267-2323 (TTY: 1-866-226-1819).
What is the Children’s Health Insurance Program (CHIP)?
CHIP offers free or low-cost Medicaid to children whose parents earn too much for Medicaid but not enough to pay for a private health plan. In some states, CHIP may also cover pregnant women and parents. Learn whether your family members qualify for CHIP through HealthCare.gov or your state’s Medicaid or CHIP agency.
Learn more about CHIP at www.insurekidsnow.gov or call 1–877–543–7669.
What other state programs can help?
**Medicare Savings Programs** in certain states may pay Medicare premiums, deductibles, and coinsurance if a person has a low income and few assets. Learn more online.
**State Health Insurance Assistance Programs (SHIPs)** give advice about health insurance in every state to people who have Medicare. SHIP counselors can help you choose the best plan for your needs. Find a SHIP counselor at ShiptaCenter.org or call 1-877-839-2675.
**State Pharmaceutical Assistance Programs** help pay for prescription medicines in certain states. Learn what programs are available in your state.
Local Resources for Care and Costs
Local health departments and clinics can help people with diabetes find medical care at little or no cost. Search for help near you at FindaHealthCenter.hrsa.gov, or call 1-877-464-4772; TTY: 1-877-897-991.
Charitable groups in your community may offer financial help for diabetes care
Lions Clubs International can help with vision care: LionsClubs.org
    Shriners Hospitals offer free treatment for children: ShrinersHospitalsforChildren.org
    Kiwanis clubs run service projects to help children and communities: Kiwanis.orgHelp Paying for Diabetes Medicines and Supplies
Don’t hesitate to speak up and talk with your health care team if you have trouble paying for your diabetes medicines and supplies. Ask if there are generic versions of the medicines you need for managing diabetes, blood pressure, and cholesterol. Generic medicines are cheaper than brand-name medicines.
Even when generic versions of medicines aren’t available, there may be different, less expensive medicines available to treat diabetes, blood pressure, and cholesterol. If you can’t afford a medicine, ask your team if you can switch to a different, less expensive medicine.
Your team may suggest other ways to help you save money, such as using free samples of glucose test strips or other supplies or contacting local programs that may provide financial support.
A health care professional talks about diabetes equipment with a man seated across a desk.Talk with your health care team if you have trouble paying for your diabetes medicines and supplies.
Drug discount programs may help you find the medicines you need for free or a lower cost. Try these resources
**BenefitsCheckUp.org.** Seniors with limited incomes can search for help with medicines, health care, rent, and other needs through this service of the National Council on Aging.
    **NeedyMeds.org.** This organization lists programs that help pay for medicines and supplies. You can search by medicine or manufacturer name.
    **Partnership for Prescription Assistance (PPARX.org).** People who don’t have insurance coverage for prescriptions may find their medicines and supplies for free or at low cost through PPARX.org.
    **RxAssist.org** lists drug-company assistance programs, state programs, discount drug cards, copay help, and more.
    **Rx Outreach** is a nonprofit, mail-order pharmacy that provides affordable medicine to people in need through its website, RxOutreach.org , or by phone at 1-888-RX0-1234 (1-888-796-1234).Websites can make it easier to find the exact medicine or supply you need at the lowest cost. Look for reputable websites that sell the same high-quality medicines as your local pharmacy.
Providers strongly advise against skipping doses of medicine or leaving some prescriptions unfilled to save money.
Help Paying for Prosthetic Care
People who have had an amputation may get help paying for rehabilitation and a prosthesis.
Organizations that may help include
**Amputee Coalition**
    Phone: 1-888-AMP-KNOW (1-888-267-5669)
    **Limbs for Life Foundation**
    Phone: 1-888-235-5462 or 405-843-5171Help Paying for Kidney Dialysis and Transplantation
Kidney failure may be a complication of diabetes. People of any age with kidney failure can get Medicare if they meet certain criteria. Learn more about Financial Help for Treatment of Kidney Failure.
Help for College Students with Diabetes
College students who have diabetes-related disabilities may face both the costs of tuition and medical expenses. These expenses may include special equipment and health costs not covered by insurance. Special equipment and support services may be available at your college, through community organizations, your state vocational rehabilitation agency, or specific disability organizations.
The HEATH Resource Center  offers information about financial aid and other types of support for college students with disabilities.
Female college student looks at a laptop computer screen while writing in a notebook.College students with diabetes may qualify for financial help with tuition and medical expenses.
Assistive Technology for Living with Diabetes
Assistive technology is any device that assists or helps someone with a disability function more safely, effectively, and independently at home, at work, and in the community. Assistive technology may include
computers with features that let people with disabilities use them more easily
    low-vision devices, such as magnifiers
    adaptive equipment, such as wheelchairs
    bathroom changes, such as adding grab bars or shower seatsThe following organizations offer information, awareness, resources, and training in assistive technology
**Able Data**
    Phone: 1-800-227-0216; TTY: 703-992-8313
    **United Cerebral Palsy**
    Phone: 1-800-872-5827 or 202-776-0406Key Terms
Some terms listed here have many meanings; only those meanings that relate to the financial and medical aspects of diabetes and its management and treatment are included.
**coinsurance:** an amount a person may still need to pay after a deductible for health care. The amount is most often a percentage, such as 20 percent.
**copay (or copayment):** an amount a person may have to pay for health care. A copay is often a set fee. A person might pay $10 or $20 for a health care provider’s visit or prescription.
**deductible:** an amount a person must pay for health care or prescriptions before the health plan(s) will pay.
**network:** a group of health care providers that gives members a discount. Some plans pay for health care and prescriptions only if received from a network provider.
**out of network:** health care providers who are not in a plan’s network. In some health plans, health care and prescriptions cost more if received from these providers.
**pre-existing condition:** a health problem a person had before the date that new health coverage starts.
**premium:** an amount a person must pay periodically—monthly or quarterly—for Medicare, other health plan, or drug plan coverage.
References
[1] American Diabetes Association. Economic costs of diabetes in the U.S. in 2017. *Diabetes Care.* 2018;41(5):917–928.        Last Reviewed June 2019
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                This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
    The NIDDK would like to thank:
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