Medicare Insulin Pumps

Does Medicare Cover Insulin Pumps?

Medicare may cover insulin and insulin pumps for people with Medicare Part B who have diabetes and meet certain conditions.

  • You have Type 1 insulin-dependent diabetes
  • Have Type 2 insulin-dependent diabetes with glucose that is difficult to control
  • Have gestational diabetes with glucose that is difficult to control
  • Your doctor must prescribe it for you
  • It is considered “Durable Medical Equipment”, which is medical equipment ordered by your doctor for use in your home

As of January, 2011, there are new guidelines for Durable Medical Goods. Medicare is using a new program called “competitive bidding to help save you and Medicare money and ensure that you get quality equipment, supplies and services. In some areas of the country, you must use specific suppliers or Medicare will not pay for the item. It’s important to see if you are affected by this new program. It is effective in the following states: CA, FL, IN, KS, KY, MO, NC, OH, PA, SC, TX (mail-order diabetes supplies come under this new rule).

You are responsible for paying 20% of the Medicare-approved amount and the Original Medicare Part B deductible applies.

Work with your doctor and healthcare providers to determine if an insulin pump is right for your diabetes treatment.