What diabetic supplies are usually covered by Medicaid?
Each state decides what types of diabetic supplies are covered through Medicaid. In addition, your state’s Medicaid program may have certain “preferred” diabetes drugs or supplies that are covered more fully. Although Medicaid is partly funded by the federal government, decisions about coverage are left to each state.
To see what supplies are covered in your state, check with your specific state Medicaid agency. You can search for your state Medicaid contacts at Medicaid.gov.
A small number of states do not cover any diabetic supplies, but most states cover some or all of the following supplies:
- Insulin
- Disposable needles for syringes
- Syringes
- Insulin pens
- Blood glucose meters
- Glucose test strips to use in the meter
- Insulin pumps (a computerized device that delivers insulin through a tube under the skin)
- Lancets to check blood glucose
- Acetone testing strips
- Ketone testing strips
- Urine glucose-ketone testing strips
- Blood glucose control and calibration solutions (used to make sure your meter and test strips are working properly)
- Glucagon emergency kits
Keep in mind, your Medicaid plan may limit diabetes testing supplies to certain brands. This means that if you already own a blood glucose testing meter, your plan might not pay for the testing strips for that meter. If you want your test strips paid for, you may have to get the preferred meter.
In 2014, due to the Affordable Care Act, some states changed how they determine coverage for Medicaid. So, if you were not eligible before 2014, you should consider applying again. If you aren’t eligible for Medicaid, there may be other ways to get your insulin and supplies for free or at a reduced cost. The American Diabetes Association recommends that you check with manufacturers to see if there are any discounts available.
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References
- Center on Budget and Policy Priorities (CBPP). Policy Basics: Introduction to Medicaid. October 21, 2020. Available at: https://www.cbpp.org/research/health/introduction-to-medicaid. [Accessed December 19, 2021].
- Medicaid.gov. Contact your state with questions. Available at: https://www.medicaid.gov/about-us/contact-us/contact-your-state-questions/index.html. [Accessed December 19, 2021].
- National Conference of State Legislatures (NCSL). State Insurance and Medicaid Coverage Requirements and Programs for Diabetes—2016. Available at: https://www.ncsl.org/Portals/1/Documents/Health/Diabetes_mandates%E2%80%942016__14504.pdf. [Accessed December 19, 2021].
- American Diabetes Association (ADA). Consumer Guide. 2021. Available at: https://consumerguide.diabetes.org/. [Accessed December 19, 2021].
- National Conference of State Legislatures (NCSL). Diabetes State Mandates and Insulin Copayment Caps. July 28, 2021. Available at: https://www.ncsl.org/research/health/diabetes-health-coverage-state-laws-and-programs.aspx. [Accessed December 19, 2021].
- Pennsylvania Department of Human Services Statewide Preferred Drug List. January 25, 2021. Available at: https://papdl.com/sites/default/files/ghs-files/Penn%20Statewide%20PDL%2001.05.21.pdf. [Accessed December 19, 2021].
- Health Partners. Medicaid List of Covered Drugs. October 2021. Available at: https://www.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/entry_218240.pdf. [Accessed December 19, 2021].
- American Diabetes Association (ADA). Medicaid and CHIP. 2021. Available at: https://www.diabetes.org/resources/health-insurance/medicaid-chip. [Accessed December 19, 2021].
- American Diabetes Association (ADA). Help with Insulin is a phone call away. 2018. Available at: https://insulinhelp.org/. [Accessed December 19, 2021].
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