Diabetes is one of the most common chronic conditions among Medicare beneficiaries in California. According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults over 65 in the United States have diabetes, and the Hispanic community faces even higher rates. If you or a family member lives with diabetes and has Medicare, it is important to understand all the benefits available to manage this condition and reduce costs.
Diabetes Supplies Covered by Medicare
Medicare Part B covers the supplies you need to monitor your blood sugar levels. This includes glucose monitors (glucometers), test strips, lancets, and control solutions. If your doctor certifies medical necessity, you can also get coverage for continuous glucose monitoring (CGM) devices, which measure your levels automatically throughout the day.
Medicare Part B also covers external insulin pumps and the insulin used with them. You generally pay 20% of the Medicare-approved amount after meeting the annual Part B deductible.
Insulin at $35 per Month: What the Law Changed
Thanks to the Inflation Reduction Act, since 2023 Medicare beneficiaries pay no more than $35 per month per covered insulin prescription. This applies to both Medicare Part D plans and Medicare Advantage plans with prescription drug coverage.
The $35 cap applies regardless of whether you are in the deductible phase, the coverage phase, or the catastrophic coverage phase of your drug plan. For many families in California who depend on insulin, this change has meant savings of hundreds of dollars per year.
Other diabetes medications
In addition to insulin, Medicare Part D covers other diabetes medications such as metformin, sulfonylureas, SGLT2 inhibitors, and GLP-1 receptor agonists. Costs vary by your specific plan and the medication's tier level. It is important to review your plan's formulary each year to confirm your medications are covered and at what cost.
Free Preventive Services for Diabetes
Medicare covers several preventive services related to diabetes at no cost to you (no deductible or copay):
- Diabetes screening tests: If you have risk factors such as family history, obesity, or high blood pressure, Medicare covers up to two fasting glucose tests per year.
- Diabetes self-management training (DSMT): Up to 10 hours of initial training and 2 additional hours each year. A certified educator teaches you to monitor your blood sugar, manage medications, plan meals, and handle diabetes in daily life.
- Medical nutrition therapy (MNT): If you have diabetes or kidney disease, Medicare covers sessions with a registered dietitian who helps you create a personalized eating plan.
- Annual Wellness Visit: Your doctor can review your diabetes management plan as part of this free annual preventive visit.
The Medicare Diabetes Prevention Program (MDPP)
If you have been diagnosed with prediabetes, Medicare offers a special program called MDPP (Medicare Diabetes Prevention Program). This year-long program includes group sessions with a health coach who helps you make sustainable lifestyle changes: improving your diet, increasing physical activity, and reaching a healthy weight.
The goal is to reduce your risk of developing type 2 diabetes. The program is covered by Medicare Part B at no additional cost. To qualify, you must have a body mass index (BMI) of 25 or higher (or 23 or higher if you are of Asian descent), a hemoglobin A1c result between 5.7% and 6.4%, and no previous diagnosis of type 1 or type 2 diabetes.
Medicare Advantage Plans with Extra Diabetes Benefits in California
Many Medicare Advantage plans in California offer additional benefits beyond what Original Medicare covers. For people with diabetes, these extra benefits can be very valuable:
- Chronic disease management programs: Some plans assign a care coordinator who helps you stay on track with appointments, medications, and health goals.
- Healthy food benefit: Several plans offer a card with monthly credit to purchase fruits, vegetables, and approved foods at participating stores.
- Medical transportation: Free or low-cost rides to your endocrinologist, labs, or pharmacy.
- Fitness programs: Access to gyms or physical activity programs such as SilverSneakers or similar offerings.
Chronic Condition Special Needs Plans (C-SNPs)
California has several C-SNP plans designed specifically for people with diabetes. These plans offer specialized provider networks, diabetes-focused drug formularies, and more intensive care coordination. If your diabetes requires ongoing attention and multiple medications, a C-SNP may be the option that best fits your needs.
To compare Medicare Advantage and C-SNP options in your county, a licensed Beneficios Medicare agent can help at no cost.
Tips for Reducing Diabetes Costs with Medicare
Managing diabetes can be expensive, but there are ways to reduce what you pay out of pocket:
- Take advantage of the $35 insulin cap. If you take insulin, confirm with your plan that you are paying no more than $35 per prescription per month.
- Apply for Extra Help. If your income is low, Medicare's Extra Help program can cover most of your prescription drug costs, including premiums, deductibles, and copays.
- Use the Medicare Savings Program (MSP). Medi-Cal can pay your Part B premiums and even some of your deductibles and copays if you qualify based on income.
- Do not skip preventive services. Self-management training and nutrition therapy are free and can help you avoid costly complications.
- Compare plans every year. Drug formularies change annually. What was affordable in 2025 may cost more in 2026. Review your options during the Annual Enrollment Period.
For an English-language guide on how Medicare plans cover preventive services, visit our preventive services guide at Medicare California.
Frequently Asked Questions
Does Medicare cover diabetes supplies?
Yes. Medicare Part B covers glucose monitors, test strips, lancets, CGM devices, and external insulin pumps. You pay 20% after the Part B deductible.
Does Medicare cover insulin?
Yes. Thanks to the Inflation Reduction Act, insulin covered by Part D or Medicare Advantage plans is capped at $35 per month per prescription.
What is the Medicare Diabetes Prevention Program?
It is a free year-long program for people with prediabetes, covered by Part B. It includes group sessions with a health coach focused on diet, physical activity, and weight loss.
Do Medicare Advantage plans cover extra diabetes benefits?
Many do. They may include nutrition programs, healthy food delivery, medical transportation, and C-SNP plans designed for people with diabetes.
Living with Diabetes and on Medicare?
Our licensed agents speak English and Spanish and can help you find the plan that best covers your medications, supplies, and diabetes care. The consultation is completely free.
Talk to an Agent TodayDo Not Face Diabetes Alone
Medicare offers more diabetes benefits than many people realize. From supplies and medications to prevention and management programs, there are resources designed to help you live better. The first step is knowing what you are entitled to and making sure your plan covers it.
Contact us today for a free review of your Medicare coverage.
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