Insurance Coverage 101

Do you know your insurance benefits? Are you paying out-of-pocket for your diabetes testing supplies? No matter what type of insurance you have, you need to know your benefits in order to reap the benefits.    ??

Testing supplies

A glucose meter, test strips, and lancets are almost always covered by insurance when you have diabetes. You do need a prescription from your doctor in order for them to be covered. Some private insurance plans cover testing supplies under durable medical equipment and not under pharmacy benefits. What this means is that if you go to your local pharmacy, they may still charge you the entire cost for the testing supplies. To use durable medical equipment benefits, you may need to pick up your supplies at a different pharmacy or use a mail order program.  Medicare covers 80 percent of the cost of diabetes testing supplies. If you have a secondary insurance policy, that one will likely pick up the additional 20 percent. If your testing supplies are not being covered, contact your insurance company.    

?Diabetes education

Diabetes is a self-managed disease so education is vital. Most private insurance plans, Medicare, and state Medicaid provide coverage for education, also referred to as diabetes self-management training. Depending on your insurance plan, there may be a limit for how many hours or visits you can receive. For example, Medicare allows for 10 hours of training, 9 of which must be spent in a group class setting. These education sessions must be done at an American Diabetes Association Recognized Education Program. Contact your insurance company to learn about your coverage for diabetes education and then find a local diabetes educator.    

Preventative services

There are also many other services that may be covered by your insurance that can help to prevent complications from diabetes. In addition to visits with your health care provider, an annual eye exam and foot exam is also recommended. These exams are both covered by Medicare. Medicare will even cover therapeutic shoes or insert if deemed necessary. 

Don’t miss out on benefits that your insurance covers. Contact your insurance company to discuss your benefits related to diabetes.