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What is covered under health insurance if I have diabetes?

Many insurance plans cover testing for prediabetes, and thanks to the Affordable Care Act, you may pay as little as $0 for prediabetes testing and even treatment in some cases (like with Medicare coverage, for example). The most common way to test for prediabetes is with an impaired glucose tolerance, or impaired fasting glucose test. To find out if this test and treatments are covered by your insurance if you’re not on Medicare, contact your insurer directly or contact your State Health Insurance Assistance Program (SHIP).

Since all insurance plans are different, this is a difficult question to answer. However, Medicare and most insurance plans cover diabetes testing for people suspected of having diabetes. People at risk for diabetes are also at risk for pre-diabetes. Since the test is the same and the risk factors are the same for both conditions, a prediabetes test may be covered. It is best to consult your physician and health insurance representative with specific coverage questions.

If your health insurance covers durable medical equipment, it may pay for a blood glucose meter, a finger-stick device, pens, pen needles, syringes, a pump, infusion sets, a continuous glucose monitor and/or an insulin injector. Some insurance plans may cover some or all of these supplies under the prescription drug benefit. As there may be differences in copayment or coinsurance depending on how your diabetes supplies are covered, be sure to check your insurance policy for clarification.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.