Medicare Coverage for Insulin and Diabetic Insulin Pumps

Patients with Type 1 and Type 2 diabetes that cannot be treated with diet, exercise or oral medication may have to have insulin injections. Insulin injections can be given via a syringe, a pre-filled injectable device called an insulin pen or by using an insulin pump.

Insulin pumps are a fairly new type of insulin delivery system. Type 1 diabetics who are no longer able to produce insulin at all in their pancreas usually use insulin pumps. The insulin pump is a computerized pump that is connected to a soft needle called a cannula that is permanently inserted under the skin. The pump includes an easy disconnection to the cannula so that the pump can be disconnected for showers and maintenance. The insulin pump then delivers the correct amount of insulin to the patient throughout the day. The patient is able to program the machine to deliver more insulin during meal times and less at night when they are sleeping. Insulin Pumps have been revolutionary for the treatment of severe diabetes. While the cannula is initially uncomfortable once the patient adapts to the sensation the discomfort goes away. The computerized system allows a diabetic to have greater freedom of mobility and negates the constant injections that are part of traditional insulin treatment.

Patient Costs Related to Diabetic Insulin Pumps

Medicare Part B covers both Insulin pumps under durable medical equipment and the Insulin used to supply the pump. In some states there are supplier restrictions related to what is covered related to insulin pumps. These states are: CA, FL, KS, KY, MO, NC, OH, PA, SC, TX. In these states a patient should check closely into the rules before ordering the pump. A Medicare approved doctor must also prescribe the pump. Diabetics who have Medicare Part D, Prescription Drug Coverage, An Advantage Plan or a Supplemental Insurance Plan should find out what parts of their Diabetic treatment is covered under each section of their insurance.

Patient Eligibility Requirements for Insulin Pumps

Before Medicare will pay for an Insulin pump and the insulin that goes into the pump, the pump must be prescribed by a Medicare-approved physician. People with Type 1 diabetes, Type 2 diabetes or insulin dependent Gestational diabetes can qualify for an Insulin pump under Medicare. Generally speaking only people that are not able to control the disease through diet, exercise and oral medication will receive Medicare coverage for an Insulin Pump.