since 2023
Medicare support and resources
Medicare and Medicare Advantage customers can access Medtronic solutions.
Medicare coverage comes with unique requirements so it’s important to have a solid plan in place before and after you enroll. Good news: a Medtronic insulin pump system, supplies, continuous glucose monitors, and smart insulin pens are covered when specific criteria are met. If you’ve used our products with another insurance plan, there will likely be some changes to your experience for you to be aware of.
What to know before you enroll in Medicare
Before you enroll in Original Medicare or Medicare Advantage (typically at age 65), here are a few things to know:
At least three months before your 65th birthday, set up a doctor appointment.
Continued coverage requires you to be seen and evaluated by the treating practitioner for your insulin pump (every three months), continuous glucose monitor (every six months), and related supplies. Before you enroll in Medicare, discuss required blood tests and next steps with your healthcare provider.
During your appointment, you will also want to confirm your doctor is registered as a Medicare provider so you can continue to see them. If your doctor does not accept Medicare, check with Medicare for recommendations.
Three months before you enroll in Medicare, get a C-peptide blood test.
To make sure you’re eligible for coverage, have your healthcare provider request a fasting C-peptide test with a simultaneously drawn fasting blood glucose test. They should send Medtronic the results prior to your Medicare enrollment.
At least one month before you switch, track daily glucose checks and set up a plan for ongoing supply orders.
Medicare requires an average of at least four checks per day during the month, or the use of a Medicare covered continuous glucose monitor (CGM) with your pump. Let your provider know how many daily blood checks you’re doing so they can document at least one month of results in your medical records. (This information may also be available within your CareLink Personal™ logbook reports.)
This is also an important time to plan for your future methods for ordering supplies. If you currently order supplies from Medtronic, you may need to get future supplies from a contracted distributor. Once you’ve received your Medicare ID card, make sure to let us know so we can help you navigate next steps.
What to know after you enroll in Medicare
To make sure things continue to run smoothly, it’s important to have a plan for ongoing supply orders. We may not be in-network which means that you might need to place future supply orders through one of our contracted distributor partners. If you’re unsure about this process, we’re here to support you every step of the way.
Let us know when you receive your Medicare ID card.
As soon as you receive your ID card, update your profile with your insurance details on Diabetes.shop. This will keep your account up to date so we can process ongoing orders with your new insurance, or allow us to help you with any changes that might be needed to your supply ordering process.
Set up automatic shipments or plan to order supplies a month in advance.
Placing your order online
- Scheduled orders: If you plan to order supplies from Medtronic, we encourage you to enroll in Scheduled orders. This will place orders on a set cadence and changes can easily be made online.
- One-time orders: If you prefer to place your orders, do this when you open your last box of supplies so your new supplies process and arrive before you run out. Order online at Diabetes.shop or by calling 1-800-646-4633, option 2 (Monday-Friday, from 8 a.m. - 6 p.m. CT.)
Shipping your order
- Medicare doesn’t allow us to deliver your order unless you have ten days or less remaining of your pump supplies. Once your order is expected to ship, we’re required to connect with you to confirm the number of supplies you have on hand before it gets shipped. When it's ready to ship, we’ll let you know when we need your input (i.e. via email or online account). All you will need to do is log in to Diabetes.shop and click on the homepage banner or the notification listed within “Advocate Actions.” Watch this video for more details.
We can continue to deliver to your preferred address but are unable to deliver to PO boxes.
Receiving your order
- To ensure your package has been received, a signature is required for all device or supply shipments.
Schedule appointments with your healthcare provider every three months.
For coverage of ongoing supply orders, it's a Medicare requirement to see your healthcare provider every three months. If you only order sensors from Medtronic, documented office visits are only needed every six months.
Traditional Fee-For-Service (FSS), or Original, Medicare refers to Medicare Part A and Part B. When eligible, you will be enrolled in Medicare Part A for hospitalizations and have the opportunity to enroll in Medicare part B for medical services and equipment coverage such as insulin pumps, pump supplies, smart pen, and continuous glucose monitors (CGMs). You also have the option to choose a Medicare Advantage Plan (Part C) instead of traditional Medicare to cover your Medtronic insulin pump, pump supplies, and CGMs. Medicare Advantage is an “all in one” alternative to traditional Medicare.
Please confirm specific coverage details, including coverage for Medtronic diabetes therapy devices and supplies with the health insurance plan. For more information on Medicare, visit www.medicare.gov.
Yes, when specific criteria are met, these devices and supplies are covered as a Medicare DME benefit under Medicare Part B. To discuss your options, call 1-800-646-4633, option 3 on Monday-Friday, 8 a.m. - 6 p.m. Central Time.
For current devices, warranty details are available in Diabetes.shop.
A Medtronic CGM is covered when used with an insulin pump system and specific criteria are met.
If your C-peptide lab results do not meet Medicare criteria for coverage, your healthcare provider can order additional tests for you (including the Beta Cell Autoantibody test.) If you have additional questions about this, please contact us.
If you have a secondary insurance plan, contact their Member Services department to find out about your benefits, coverage requirements, and any financial responsibility you may have.
For an insulin pump, CGM, and ongoing supplies to be covered, Medtronic will request your healthcare provider to send us written documentation with:
- Your diabetes diagnosis
- Confirmation that you’re checking blood glucose an average of four times a day within each month or using a therapeutic CGM for the month prior to Medicare enrollment
- The Medicare required fasting C-peptide blood test or Beta Cell Antibody test
Some additional blood tests from a lab may be required so check with your healthcare provider.
Once enrolled in traditional Medicare or Medicare Advantage, your orders might need to be fulfilled through a different supply company that is contracted with Medicare. There are several companies that Medtronic partners with who will support you along the way. Call us to discuss potential changes and recommended next steps at 1-800-646-4633, option 2 on Monday-Friday, 8 a.m. - 6 p.m. Central Time.
We encourage you to enroll in Scheduled Orders so that your supplies are prepared on a set cadence. If you want to place a one-time order, placing your next order when you open your last box of supplies to so there’s enough time for it to process.
For your pump supplies, Medicare requires Medtronic to confirm the number of supplies that you have on hand within 10 days of your next scheduled ship date before we can ship your next supply order. Watch this video for more on how that works. For sensors, Medicare allows reorders based on your last order date and the quantity in your last order.
Supply ordering needs, contact customer support: 1-800-646-4633, option 2 on Monday-Friday, 8 a.m. - 6 p.m. Central Time
Help with a current product, contact 24-hour Tech support: 1-800-646-4633, option 1
Financial support programs: Review our available programs
Medicare guidelines and resources: 1-800-MEDICARE (1-800-633-4227) or http://www.medicare.gov.
