If you have diabetes or are at risk for it, Medicare covers a lot. Insulin copays are capped at $35 a month. Continuous glucose monitors are covered for many users. Therapeutic shoes, foot exams, prevention programs, and self-management training are all included. Here is what is available in 2026.
The big rule: Insulin is capped at $35 per month per prescription
Thanks to the Inflation Reduction Act, Medicare caps insulin copays at $35 per month per prescription. This applies to:
- All insulin covered under Part D drug plans
- Insulin used in pumps (covered under Part B durable medical equipment)
- All major insulin brands on the formulary
This cap took effect in 2023 and is permanent. Before the cap, some seniors paid $300 or more per month for insulin. Now, the most you pay for a 30-day supply is $35, no matter which insulin you use.
What Medicare covers for diabetes
Insulin (under Part D)
All insulin types on your Part D plan's formulary are covered with the $35 monthly cap. Some plans have additional cost-sharing for insulin not on their preferred formulary, but the cap applies.
Insulin used in insulin pumps (under Part B)
If you use an insulin pump, the insulin and pump supplies are covered under Part B as durable medical equipment. The $35 cap also applies here, plus the standard 20 percent Part B coinsurance which Medigap covers.
Blood sugar test strips, lancets, and meters
Covered as durable medical equipment under Part B. You pay 20 percent after your Part B deductible.
Medicare has preferred test strip brands. If you use a non-preferred brand, your costs go up. Ask your supplier about preferred options.
Continuous glucose monitors (CGMs)
Medicare expanded CGM coverage in 2023. You qualify for a covered CGM if:
- You have diabetes (Type 1 or Type 2)
- You use insulin (3+ daily injections or an insulin pump) OR
- You have a history of frequent low blood sugar (hypoglycemia)
Most major CGMs are covered, including:
- Dexcom G6 and G7
- FreeStyle Libre 2 and 3
- Medtronic Guardian Connect
You pay 20 percent under Part B. Medigap covers most or all of that. CGMs can cost $1,000 to $3,000 per year out of pocket without coverage, so this benefit is significant.
Diabetes self-management training (DSMT)
Medicare covers up to 10 hours of self-management training in your first year of diabetes diagnosis, plus 2 hours per year after. The training covers:
- How diabetes affects your body
- Healthy eating and exercise
- Medication use
- Blood sugar monitoring
- Complications and how to prevent them
Your doctor refers you to a Medicare-approved DSMT program. You pay 20 percent under Part B (Medigap covers most of that).
Medical nutrition therapy (MNT)
If you have diabetes, kidney disease, or have had a recent kidney transplant, Medicare covers nutrition counseling from a registered dietitian. The first year covers 3 hours of one-on-one counseling, plus 2 hours per year after.
You pay nothing for MNT. It's a preventive benefit with no cost-sharing.
Therapeutic shoes and inserts for diabetics
If you have diabetes-related foot conditions, Medicare covers one pair of therapeutic shoes plus three pairs of inserts per year. Or, one pair of custom-molded shoes with two extra pairs of inserts if standard shoes don't work for your feet.
You pay 20 percent under Part B. Conditions that qualify include:
- Diabetic neuropathy
- Poor circulation
- History of foot ulcers
- Foot deformity
- Previous amputation of any part of either foot
Annual foot exam for diabetics
Medicare covers one foot exam every 6 months for diabetics with peripheral neuropathy (loss of sensation in the feet). The exam includes a check for signs of injury, ulcers, and circulation problems.
Annual eye exam for diabetics
Medicare covers one diabetic retinopathy exam per year. The exam checks for diabetic eye disease and is performed by an eye doctor. You pay 20 percent under Part B.
Diabetes Prevention Program (MDPP)
If you don't have diabetes yet but you are at risk based on blood sugar and weight, Medicare covers a 12-month diabetes prevention program. It includes:
- Group sessions with a trained coach
- Weekly meetings for the first 6 months
- Monthly meetings for the next 6 months
- Focus on weight loss, healthy eating, and physical activity
The Medicare Diabetes Prevention Program is once in a lifetime. You pay nothing.
Special Needs Plans for diabetics
Some Medicare Advantage plans are Chronic Condition Special Needs Plans (C-SNPs) designed specifically for diabetics. These plans offer:
- Lower copays for diabetes-related services
- Larger grocery allowances for healthy food
- Better diabetic supply coverage
- Specialty pharmacist support
If you have well-controlled diabetes and a C-SNP is available in your area, it may be worth considering. C-SNPs have specific eligibility requirements.
What Medicare doesn't cover for diabetes
- Over-the-counter glucose tablets or gels (some MA plans cover via OTC allowance)
- Most weight-loss programs other than the Diabetes Prevention Program
- Vitamins and supplements
- Routine podiatry beyond what's covered for diabetics
- Acupuncture for diabetic neuropathy
How to make sure you're using all your diabetes benefits
- Ask your doctor about diabetes self-management training. Most diabetics qualify and never use it.
- Get the annual foot exam, eye exam, and check up on therapeutic shoes. All covered, most diabetics skip them.
- If you take insulin, ask about a CGM. Massive quality-of-life improvement and now covered.
- Use your Part D drug plan's $35 insulin cap. Make sure your insulin is in your plan's formulary.
- Look at C-SNP options during Annual Enrollment if you want a plan optimized for diabetes care.
Common mistakes
Mistake 1: Paying retail for insulin
If you are paying more than $35 a month for any insulin on your Part D plan, something is wrong. Call your plan and ask why. The cap is federal law and applies to every insulin on every Part D plan.
Mistake 2: Not getting CGM coverage
Many diabetics on insulin don't realize CGMs are covered. Ask your endocrinologist or primary care doctor about a CGM if you check your blood sugar multiple times a day.
Mistake 3: Skipping the diabetes prevention program
If you have prediabetes, the MDPP is a free 12-month program with proven results. It is once in a lifetime, so use it when you qualify.
Mistake 4: Not using preferred test strip brands
Test strips have huge price differences by brand. Ask your supplier about Medicare-preferred brands. The same blood sugar reading on a different test strip can cost half as much.
The bottom line
Medicare diabetes coverage in 2026 is significantly better than it was a few years ago. The $35 insulin cap, expanded CGM coverage, and existing benefits like DSMT and therapeutic shoes add up to real savings and better care.
The biggest issue is awareness. Most diabetics never claim half of what they're entitled to. Talk to your doctor about every benefit on this list. Each one helps you manage diabetes better and avoid expensive complications.
