Medicare and Diabetes: What’s Covered and How to Reduce Your Costs

Diabetes is one of the most common chronic conditions among Medicare beneficiaries. If you have diabetes and are on Medicare, or are approaching Medicare eligibility, understanding your coverage is essential for both your health and your wallet.

The good news: Medicare covers many diabetes-related services and supplies. The challenge: there are cost-sharing responsibilities and coverage gaps that can add up quickly without the right supplemental coverage.

This guide walks through what Medicare covers for diabetes, what it costs, and how to fill the gaps.

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How Many Medicare Beneficiaries Have Diabetes?

According to the Centers for Disease Control and Prevention, approximately one in three Medicare beneficiaries has been diagnosed with diabetes. It is one of the leading drivers of Medicare spending and one of the most important health conditions to manage well.

Poorly managed diabetes leads to complications including heart disease, kidney failure, vision loss, neuropathy, and lower-limb amputations, all conditions with significant Medicare cost implications.

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What Medicare Part B Covers for Diabetes

Medicare Part B covers a range of outpatient diabetes services. After meeting your Part B Deductible ($283 in 2026), you are responsible for 20% of the Medicare-approved amount for most of these services.

Blood Sugar (Glucose) Testing Supplies

Part B covers diabetes testing supplies, including blood glucose meters, lancets, test strips, and lancet devices. Coverage depends on whether you use insulin and other factors:

• If you use insulin: Medicare covers up to 3 tests per day (or more if Medically necessary)
• If you do not use insulin: Medicare covers 1 test per day (or more with documentation of Medical necessity)

You must get your supplies from a Medicare-enrolled Supplier. Mail-order suppliers are available and often more convenient.

Continuous Glucose Monitors (CGMs)

Continuous Glucose Monitors are covered under Part B as Durable medical equipment when prescribed by a doctor. CGM systems have become increasingly important for managing Type 1 and Type 2 diabetes, and Medicare coverage has expanded in recent years to include many CGM devices.

Therapeutic Shoes and Inserts

If you have diabetes with certain foot conditions, Medicare covers therapeutic shoes and inserts once per year: one pair of extra-depth shoes and up to three pairs of inserts, or one pair of custom-molded shoes.

This benefit is often overlooked. Diabetic foot complications are serious, and proper footwear is an important preventive measure.

Diabetes Self-Management Training (DSMT)

Medicare Part B covers Diabetes Self-Management Training (DSMT), education and training to help you manage your diabetes on your own. Coverage includes:

• 10 hours of initial training (if newly diagnosed or newly enrolled)
• 2 hours of follow-up training per year

A physician must refer you, and the program must be an accredited DSMT program. This is a valuable benefit that many beneficiaries never use.

Medical Nutrition Therapy (MNT)

For beneficiaries with diabetes (or kidney disease), Medicare covers Medical Nutrition Therapy (MNT), individualized dietary counseling with a registered dietitian.

Coverage includes:

• 3 hours of MNT in the first year
• 2 hours each subsequent year
• Additional hours if a doctor determines your condition has changed

Preventive Services for Diabetes

For beneficiaries at high risk for diabetes, Medicare Part B covers:

• Fasting blood glucose tests, up to two per year at no cost (no deductible or Coinsurance)
• Diabetes prevention program, for those who meet certain pre-diabetes criteria

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What Medicare Part A Covers for Diabetes

If you are hospitalized due to a diabetes-related condition (severe hypoglycemia, diabetic ketoacidosis, a complication requiring surgery, or a related condition), Medicare Part A covers inpatient hospital care subject to the Part A deductible ($1,676 in 2026 for each Benefit period).

Part A also covers Skilled nursing facility care following a qualifying inpatient hospital stay, which is relevant for serious diabetes complications requiring rehabilitation.

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What Medicare Part D Covers for Diabetes

Prescription insulin and diabetes medications are covered under Medicare Part D (Prescription Drug Coverage), not Part B.

This is an important distinction. Part B covers testing supplies and durable medical equipment; Part D covers the drugs.

Insulin Costs Under Part D

In recent years, Congress has taken action to cap insulin costs for Medicare Part D enrollees. Beginning in 2024, Medicare beneficiaries pay no more than $35 per month for each covered insulin, regardless of the plan they are on.

This is a significant change from prior years when insulin costs under Part D could be much higher. If you use insulin and are approaching Medicare eligibility, this cap is worth knowing.

Other Diabetes Medications

Oral diabetes medications (metformin, GLP-1 agonists, SGLT-2 inhibitors, etc.) are covered under Part D. The cost depends on your specific plan’s Formulary (the list of covered drugs) and the tier your medication falls into.

When choosing a Part D plan, it is essential to check whether your specific diabetes medications are on the formulary and what tier they are placed on. A drug on Tier 3 or Tier 4 can cost significantly more than the same drug on Tier 1 or Tier 2.

Insulin Through Part B vs. Part D

This is a common source of confusion. As a general rule:

• Insulin used with an insulin pump may be covered under Part B as durable medical equipment
• Insulin delivered by injection or pen is typically covered under Part D

If you use an insulin pump, this distinction matters for understanding which part of Medicare pays and what your cost-sharing will be.

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What Medicare Does NOT Cover for Diabetes

Understanding the coverage gaps helps you plan.

Over-the-counter medications and supplies: Many over-the-counter diabetes-related products, including certain glucose gels, some dietary supplements, and OTC monitoring supplies that don’t meet Medicare criteria, are not covered.

Most dental care: Diabetes increases the risk of gum disease. However, Medicare does not cover routine dental care. This is a real gap for diabetics who need more frequent dental attention.

Most vision care: Diabetes is a leading cause of blindness. Medicare covers some diabetic retinopathy screening under Part B, but routine eye exams and eyeglasses are generally not covered by Original Medicare.

Foot care exceptions: While therapeutic diabetic shoes are covered, routine foot care is generally not covered by Medicare unless you meet specific criteria for high-risk foot care.

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How Medigap Helps People with Diabetes

Original Medicare leaves you responsible for 20% of Part B costs with no cap. If you’d like a fuller picture of how Medicare cost-sharing works, our guide on Medicare out-of-pocket expenses, copays, and coinsurance explains the basics. For someone with diabetes who uses multiple services (doctor visits, lab tests, specialist visits, CGM supplies, education programs), that 20% adds up quickly.

A Medicare Supplement Plan G covers that 20% coinsurance. After you pay the Part B deductible once per year, Plan G picks up 100% of the remaining approved costs.

For a diabetic Medicare beneficiary who sees their endocrinologist quarterly, has regular lab work, uses a CGM, attends DSMT sessions, and has occasional hospitalizations, a Medigap plan can provide thousands of dollars in annual savings compared to Original Medicare alone. If you’re still weighing whether the extra Premium is worth it, our guide on whether Medicare Supplement plans are worth the cost walks through the math.

Medicare Advantage and diabetes: Medicare Advantage Plans often add dental and vision benefits, which can be appealing for diabetics who need those services. However, MA plans also use provider networks, prior authorizations, and cost-sharing that can create barriers for complex care. People with serious diabetes complications often find that unrestricted access to specialists, available with Original Medicare plus Medigap, is more valuable.

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Tips for Managing Diabetes Costs on Medicare

Use your DSMT benefit. Only a small percentage of Medicare beneficiaries with diabetes actually use the Diabetes Self-Management Training benefit. It is covered, it is valuable, and it can help you manage your condition more effectively, reducing long-term costs.

Check your Part D formulary every year. Drug plans change their formularies annually. During the Annual Enrollment Period (October 15–December 7), review whether your medications are still covered at the same tier, and switch if you find a better match.

Use in-network DME suppliers. For testing supplies and CGMs, using a Medicare-enrolled supplier ensures Part B covers your costs. Ask your doctor or Medicare advisor for a Referral if needed.

Take advantage of the $35 insulin cap. If you use insulin and are paying more than $35 per month per insulin, contact your Part D plan or pharmacist. The cap applies to all covered insulins under Medicare Part D.

Ask about the diabetes prevention program. If you are at risk for diabetes (pre-diabetic), Medicare covers a structured prevention program that can delay or prevent the onset of Type 2 diabetes.

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Frequently Asked Questions

Does Medicare cover CGM sensors and transmitters?
Yes. Medicare Part B covers CGM systems, including sensors and transmitters, as durable medical equipment when prescribed by a physician and meeting Medicare criteria.

What if my doctor wants me to test my blood sugar more than the standard number of times per day?
If your physician documents that additional testing is medically necessary, Medicare can cover more frequent testing. Documentation is key.

My insulin is very expensive. What can I do?
As of 2024, Medicare Part D caps insulin costs at $35 per month per covered insulin. If you are paying more, contact your plan or pharmacist to confirm the cap is being applied.

Does Medicare cover weight loss programs for diabetes management?
Medicare covers the Diabetes Prevention Program (DPP) for certain at-risk beneficiaries, and Medical Nutrition Therapy for those with diagnosed diabetes. Coverage for broader weight loss programs varies.

Can I use my HSA for diabetes-related expenses on Medicare?
Yes. If you have an existing HSA balance when you enroll in Medicare, you can continue using those funds for qualified medical expenses, including most diabetes-related costs. You cannot make new HSA contributions after enrolling in Medicare.

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Bottom Line

Medicare provides meaningful coverage for people with diabetes: testing supplies, medications, education, preventive services, and more. But the 20% coinsurance under Part B and the potential costs of hospitalizations and SNF care can still add up significantly.

A well-chosen Medigap plan can cap those out-of-pocket costs and give you the financial predictability you need to focus on your health.

Want to see what a Medigap plan would cost in your area? Get a free, no-obligation quote from REMEDIGAP today.

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This article is for educational purposes. Medicare coverage details and cost amounts change annually. Verify current coverage at Medicare.gov or speak with a licensed Medicare advisor.

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