Medicare Part B is an important facet of diabetes coverage
Part B is the basic coverage for medical expenses such as doctor's fees, some exams and tests, certain outpatient care in a clinic or hospital, and approved screening shots. These are basic services not covered under Medicare Part A, which provides for hospitalization coverage. Part B usually does not pay 100% of a specific cost: it pays the Medicare share, and you must make up the difference.Medicare Part B is optional; you must sign-up for it.
In addition to general services for doctor's fees and other services, Part B also covers some diabetes-specific supplies and services. These can incude blood glucose testing monitors, blood glucose test strips, lancet devices and lancets, and glucose control solutions. You might also qualify for therapeutic shoes and diabetes self-management training.
Some preventative care services are usually available also; these include a physical exam by your doctor when you are first enrolled in Medicare, diagnostic screenings for diabetes, tests for Glaucoma, and screenings for cardiovascular illness. (For other Medicare topics, see our home page The Medicare Project - home)
This summary was prepared using information from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244-1850 - www.medicare.gov, and Tthe American Diabetes Association, www.diabetes.org/home.jsp.
Web pages and brochures from government, education, and non-commercial sites about these subjects:
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web page: Medicare Part B - What Does It Cover? source:New York State Office for the Aging languages: English from the web page: (date:2005) "...You do not have to enroll in Medicare Part B. However, if you decline to enroll when you are first eligible, and then decide to sign up later, you may have to pay extra for the coverage. Your monthly premium will increase by 10% for each 12 month period that you could have had Part B but did not sign up for it. You will have to pay this extra amount each month for as long as you have Part B, except in special cases... " more from American Diabetes Association: Medicare brochure: What You Should Know About Diabetes and Medicare 1 page; languages: English from the brochure: "Starting in 2005, Medicare will offer new preventive and screening benefits that are important to the fight against diabetes. This means for seniors at risk for diabetes or those already diagnosed with pre-diabetes and diabetes, these services will be covered at little or no cost to you..." web page: Part B Medicare Benefits for Medical Nutrition Therapy languages: English from the web page: "Are you in need of more in-depth information about the Medicare Part B benefit, which covers Medical Nutrition Therapy (MNT) for people with diabetes and renal disease?..." |
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web page:
Medicare-Covered Diabetes Services and Supplies
source:Medicare Rights Center
languages: English
topics on the web page: "Diabetes self-management training and education; Certain diabetic supplies; Insulin; Foot-care for diabetics with peripheral neuropathy; Therapeutic shoes** for people with severe diabetic foot disease; Medical nutritional therapy; Glaucoma screenings; and non-covered items"
web page:
Preventive Services) - Diabetes Screening, Supplies, and Self-Management Training
source:Medicare.gov - The Official U.S. Government Site for People with Medicare
languages: English, Spanish
from the web page: "...For people with Medicare at risk for getting diabetes, Medicare covers a screening blood sugar test to check for diabetes. You are considered at risk if you have any of the following: high blood pressure, dyslipidemia (history of abnormal cholesterol and triglyceride levels), obesity, or a history of high blood sugar. Other risk factors may also qualify you for this test and based on the results, you may be eligible for up to two screenings each year. Medicare also covers certain supplies and self-management training to find and treat diabetes..."
web page:
Medicare Coverage of Therapeutic Footware for People with Diabetes
source:National Diabetes Education Program
languages: English
from the web page: "... Medicare provides coverage for depth-inlay shoes, custom-molded shoes, and shoe inserts for people with diabetes who qualify under Medicare Part B. Designed to pre vent lower-limb ulcers and amputations in people who have diabetes, this Medicare benefit can pre vent suffering and save money... How Individuals Qualify ..."
more from National Diabetes Education Program:
web page:
Does Medicare help pay for other services and supplies for people with diabetes?
languages: English
from the web page: "Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies covered by Medicare include..."
Medicare-Covered Diabetes Services and Supplies
source:Medicare Rights Center
languages: English
topics on the web page: "Diabetes self-management training and education; Certain diabetic supplies; Insulin; Foot-care for diabetics with peripheral neuropathy; Therapeutic shoes** for people with severe diabetic foot disease; Medical nutritional therapy; Glaucoma screenings; and non-covered items"
Preventive Services) - Diabetes Screening, Supplies, and Self-Management Training
source:Medicare.gov - The Official U.S. Government Site for People with Medicare
languages: English, Spanish
from the web page: "...For people with Medicare at risk for getting diabetes, Medicare covers a screening blood sugar test to check for diabetes. You are considered at risk if you have any of the following: high blood pressure, dyslipidemia (history of abnormal cholesterol and triglyceride levels), obesity, or a history of high blood sugar. Other risk factors may also qualify you for this test and based on the results, you may be eligible for up to two screenings each year. Medicare also covers certain supplies and self-management training to find and treat diabetes..."
Medicare Coverage of Therapeutic Footware for People with Diabetes
source:National Diabetes Education Program
languages: English
from the web page: "... Medicare provides coverage for depth-inlay shoes, custom-molded shoes, and shoe inserts for people with diabetes who qualify under Medicare Part B. Designed to pre vent lower-limb ulcers and amputations in people who have diabetes, this Medicare benefit can pre vent suffering and save money... How Individuals Qualify ..."
more from National Diabetes Education Program:
web page:
Does Medicare help pay for other services and supplies for people with diabetes?
languages: English
from the web page: "Medicare helps pay for certain services and supplies for people with diabetes who have Medicare Part B. All require a doctor's prescription. The diabetes-related services and supplies covered by Medicare include..."
Medicare and Renal Disease
There is a national health insurance program for people with ESRD, and its called "The Medicare End Stage Renal Disease Program". It is designed to encourage self-care dialysis and kidney transplantation, as well as clarify reimbursement procedures to achieve effective cost control.*The description above is from U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244-1850 - www.cms.hhs.gov/
web page:
Financial Help for Treatment of Kidney Failure
source:National Kidney and Urologic Diseases Information Clearinghouse
languages: English, Spanish
from the web page: "...In 1972, Congress passed legislation making people of any age with permanent kidney failure eligible for Medicare, a program that helps people over 65 and people with disabilities pay for medical care, usually up to 80 percent. Other public and private resources can help with the remaining 20 percent. Your dialysis or transplant center has a social worker who can help you locate and apply for financial assistance...."
web page:
Medicare End Stage Renal Disease Program
source:Centers for Medicare & Medicaid Services
languages: English
from the web page: "...The Medicare End Stage Renal Disease Program is a national health insurance program for people with ESRD. The program is designed to encourage self-care dialysis and kidney transplantation and clarify reimbursement procedures to achieve effective cost control.... "
brochure:
MOST ESRD PATIENTS WILL FALL INTO THE MEDICARE “DOUGHNUT HOLE”
source:American Society of Nephrology
file size:2 pg. languages: English date:November 2006
from the brochure: "Kidney Patients Face High Drug Costs under Part D Plans...Washington, DC (August 2, 2006) — Medicare beneficiaries with end-stage renal disease (ESRD) are a high-risk group for increased medication costs related to a gap in coverage—the so-called "doughnut hole," or lack of prescription drug benefits between $2,251 and $5,100 in medication expenses—in the Medicare Part D prescription drug benefit, suggests a study in the September Journal of the American Society of Nephrology..."
brochure:
ESRD Patients’ Experience with Medicare Part D
source:The American Kidney Fund
file size:2 pg. languages: English date:November 2006
from the brochure: "...the American Kidney Fund (AKF) designed and conducted a survey of dialysis and transplant social workers in October 2006 to assess ESRD patients’ overall experience with Part D. AKF later commissioned Avalere Health to analyze the survey results and to write this report. The AKF provides direct financial assistance to ESRD patients for treatment-related expenses, including prescription drug costs that are not covered by insurance or any other means. AKF undertook this study to inform the design of a new program to assist patients with their Part D cost sharing...."
web page:
Lessons for Medicare Part D in the hemodialysis community
source:BioMed Central
date: July, 2006; languages: English
from the web page: (Research article) "...Medicare beneficiaries without prescription drug coverage consistently fill fewer prescriptions than beneficiaries with some form of drug coverage due to cost. ESRD patients, who are disproportionately poor and typically use multiple oral medications, would likely benefit substantially from any form of prescription drug coverage. Because most hemodialysis patients are Medicare-eligible, they as well as their providers would be expected to be well informed of changes in Medicare prescription drug coverage..." BMC Nephrology 2006
Financial Help for Treatment of Kidney Failure
source:National Kidney and Urologic Diseases Information Clearinghouse
languages: English, Spanish
from the web page: "...In 1972, Congress passed legislation making people of any age with permanent kidney failure eligible for Medicare, a program that helps people over 65 and people with disabilities pay for medical care, usually up to 80 percent. Other public and private resources can help with the remaining 20 percent. Your dialysis or transplant center has a social worker who can help you locate and apply for financial assistance...."
Medicare End Stage Renal Disease Program
source:Centers for Medicare & Medicaid Services
languages: English
from the web page: "...The Medicare End Stage Renal Disease Program is a national health insurance program for people with ESRD. The program is designed to encourage self-care dialysis and kidney transplantation and clarify reimbursement procedures to achieve effective cost control.... "
MOST ESRD PATIENTS WILL FALL INTO THE MEDICARE “DOUGHNUT HOLE”
source:American Society of Nephrology
file size:2 pg. languages: English date:November 2006
from the brochure: "Kidney Patients Face High Drug Costs under Part D Plans...Washington, DC (August 2, 2006) — Medicare beneficiaries with end-stage renal disease (ESRD) are a high-risk group for increased medication costs related to a gap in coverage—the so-called "doughnut hole," or lack of prescription drug benefits between $2,251 and $5,100 in medication expenses—in the Medicare Part D prescription drug benefit, suggests a study in the September Journal of the American Society of Nephrology..."
ESRD Patients’ Experience with Medicare Part D
source:The American Kidney Fund
file size:2 pg. languages: English date:November 2006
from the brochure: "...the American Kidney Fund (AKF) designed and conducted a survey of dialysis and transplant social workers in October 2006 to assess ESRD patients’ overall experience with Part D. AKF later commissioned Avalere Health to analyze the survey results and to write this report. The AKF provides direct financial assistance to ESRD patients for treatment-related expenses, including prescription drug costs that are not covered by insurance or any other means. AKF undertook this study to inform the design of a new program to assist patients with their Part D cost sharing...."
Lessons for Medicare Part D in the hemodialysis community
source:BioMed Central
date: July, 2006; languages: English
from the web page: (Research article) "...Medicare beneficiaries without prescription drug coverage consistently fill fewer prescriptions than beneficiaries with some form of drug coverage due to cost. ESRD patients, who are disproportionately poor and typically use multiple oral medications, would likely benefit substantially from any form of prescription drug coverage. Because most hemodialysis patients are Medicare-eligible, they as well as their providers would be expected to be well informed of changes in Medicare prescription drug coverage..." BMC Nephrology 2006