Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What does Medicare cover for a patient using metformin without insulin regarding glucose monitoring supplies?

1. All diabetes supplies

2. A meter and 100 strips per month

3. The meter only

4. A meter and 100 strips every 3 months

The correct answer is: A meter and 100 strips every 3 months

The correct answer reflects Medicare’s specific coverage guidelines for patients who are not using insulin but are on oral diabetes medications such as metformin. For these patients, Medicare covers a blood glucose meter and test strips, but the coverage is limited to a certain quantity over a specified period. In the case of a patient using metformin, Medicare provides coverage for a meter and 100 test strips every three months. This is aligned with the requirement that diabetes supplies must be necessary for the management of diabetes, and since insulin users generally receive more frequent testing than those on oral medications, the quantities differ. By providing this specific amount every three months, Medicare ensures that patients can monitor their glucose levels effectively while managing their diabetes treatment plan without excess waste. This structured coverage helps ensure access to necessary equipment while balancing cost and resource allocation. It’s important to note that the guidelines for coverage may vary based on additional factors like the patient's specific needs, their physician's recommendations, and whether or not the patient has other diabetes management issues that warrant more frequent monitoring.