Needles, Numbers, and Networks: A Real Talk on Diabetes and Insurance
Cakes and pies are tasty treats—but have you ever thought about the real cost of diabetes?
In 2021, 38.4 million Americans—about 11% of the population—are living with diabetes. According to a 2021 study by the American Diabetes Association, nearly 3 in 10 of those are seniors. Clearly, diabetes touches a lot of lives, which is why it’s so important to understand how it can impact your health coverage.
Continuous Glucose Monitors
Continuous Glucose Monitors (CGMs) are an essential tool for managing diabetes—but they don’t come cheap. Without insurance, they can cost anywhere from $135 to $400 a month.
If you're on Medicare, you might have already run into some challenges when it comes to getting the supplies you need at an affordable price. And if you're new to Medicare, here's something important to know: CGMs are covered under Medicare Part B. That means Medicare pays 80% of the cost, and you're responsible for the remaining 20%.
Now, if you have a Medicare Supplement plan, the good news is it will likely cover that 20% for you—once you’ve met your annual deductible, of course.
If you’re on a Medicare Advantage plan, coverage can vary. Some plans offer CGMs at no cost to you, while others may charge up to 20%. It all depends on your plan’s Evidence of Coverage, so it’s a good idea to take a look or give your plan a call to find out exactly what’s included.
Here are some average costs (without insurance) of Continuous Glucose Monitors you’ll recognize.
FreeStyle Libre 3 - $135.99/month
Dexcom G6 - $172.53/month
Dexcom G7 - $404.63/month
Guardian 4 - $280/ 5-weeks
Insulins
Here’s what you should know about insulin coverage on Medicare:
Traditional insulin administered without an insulin pump is covered by Medicare Part D.
In 2025, the cost for insulin is capped at $35.
You do not have to pay a deductible before receiving insulins.
Medicare Part B does not cover insulin-related supplies (i.e. Syringes, Needles, Alcohol swabs, Gauze etc.)
Learn more about insulin coverage on Medicare at Medicare.gov
Other Tips & Tricks
Medicare may also cover therapeutic shoes and inserts—and depending on your plan, you could pay little to nothing out of pocket for them!
You might also qualify for the Federal Extra Help Program, which helps lower the cost of your diabetes medications. This program is based on your income, so it’s worth checking to see if you’re eligible.
Another money-saving tip: make sure your pharmacy is in-network with your Medicare plan. Even better, try to use a preferred in-network pharmacy, as that can help you save even more.
And don’t forget to stay in touch with your Medicare agent and review your plan every year. Drug lists (called formularies) can change, so it’s important to make sure your medications are still covered. You can make changes to your plan each year during Medicare’s Annual Enrollment Period from October 15 to December 7.
Advance Diabetic Supplies
At Schopmeyer Medicare, Health & Life, we’re proud to partner with Advanced Diabetic Supplies (ADS) to help our clients get their diabetic supplies quickly and affordably.
So, what is ADS?
It’s truly our pleasure to connect you with ADS—a trusted, nationwide supplier that’s dedicated to making the process as smooth and stress-free as possible.
Here’s how ADS makes things easy for you:
They’ll reach out 14 days before you’re eligible for a refill, so you never run out of supplies.
An ADS representative works directly with your doctor to gather any necessary information—saving you time and hassle.
Free shipping right to your door!
We’re here to support you every step of the way. If you have any questions or need help getting started with ADS, just reach out—we’re happy to help!
