Most health plans cover diabetes supplies, but some do not. Insurance coverage can be confusing and you may not know who to ask for help. Make the most of your benefits by finding out how your plan covers your diabetes supplies.

Coverage for diabetes supplies is now better than ever because:

1. Most health plans realize that blood sugar monitoring is necessary to manage and control diabetes, thereby preventing costly complications.
2. Many state and federal Medicare laws now require health plans to cover some percentage of diabetes supplies. Some require you to pay up front and reimburse you for a certain percentage. Others charge a co-pay or only provide coverage after you meet your deductible.

What Are "Diabetes Supplies"?

1. A blood sugar monitor
2. Test strips and lancets
3. Monitor batteries
4. Replacement spring-loaded devices
5. Control solution or chips

What Diabetes Supplies Does Your Health Plan Cover?
It's important to understand your health care plan. General information about various types of plans and coverage is provided in the Insurance Coverage Overview. It is also advisable for you to call your insurance or plan provider for details regarding your benefits.

Which Benefit Covers Your Supplies?
In addition to knowing what supplies are covered, you also need to know which benefit they're covered under. For example, diabetes medications may be covered under your pharmacy or prescription benefit, while test strips often are covered under the major medical or Durable Medical Equipment (DME) coverage of your health plan.

If you have specific questions about what your plan covers, call the toll-free number on the back of your health plan card. If you don't feel you are getting correct information, ask for a supervisor. If a claim is denied, remember you have the right to appeal.

Questions to Ask Your Health Plan Provider

1. Do you cover diabetes supplies?
2. What supplies do you cover?
3. What quantity of supplies do you cover within a given time period?
4. Are diabetes supplies covered as a prescription benefit or under another benefit such as DME?
5. Do I need a prescription from my health care provider?
6. What needs to be specified in a prescription?
7. Will I have to pay up front and submit the claim for reimbursement or just pay a co-pay?
8. What do I need to submit for coverage (eg, claim form, copy of prescription)?
9. Can I save money and/or get a larger quantity of supplies if I use a mail-order company? If so, how do I sign up?