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 and supplies are covered when specific criteria are met. If you’ve used our products with another insurance plan, there will be some changes to your experience you should be aware of.
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What to know before you enroll in Medicare
Before you enroll (typically at age 65), here are three things you need to know:
At least three months before your 65th birthday, set up a doctor appointment.
Before you switch, discuss required blood tests and next steps with your healthcare provider. During your appointment, you will also want to confirm they are registered as a Medicare provider so you can continue to see them.
If they are not a Medicare provider, check with Medicare for recommendations on who you can see after you’ve switched.
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 us the results prior to your Medicare enrollment.
At least one month before you switch, track your daily glucose checks.
Medicare requires an average of at least four checks per day, 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.).
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
Let us know when you receive your Medicare ID card.
As soon as you receive your ID card, update your profile with insurance details on Diabetes.shop. This will keep your account up to date so we can process ongoing orders with your new insurance.
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 for automatic recurring shipments with Scheduled orders. This will allow orders to be placed on a set cadence and changes can easily be made online.
- One-time orders: If you prefer to place your orders yourself, do this when you open your last box of supplies. 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 10 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. We can continue to deliver to your preferred address but are unable to deliver to PO boxes.
Receiving your order
- A signature will now be 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.
Original Medicare refers to Medicare Part A and Part B. You will, upon eligibility, have the opportunity to enroll with Medicare Part A for hospitalization and with Part B for medical equipment coverage such as Medtronic insulin pumps, pump supplies, and sensors.
You also have the option to choose a Medicare Advantage Plan (Part C) instead of original Medicare to cover your Medtronic insulin pump, pump supplies, and sensors. Medicare Advantage is an “all in one” alternative to Original Medicare. If you’re planning on signing up for a Medicare Advantage plan, please confirm the specific details for coverage with the company that you select to understand whether they cover Medtronic supplies. Supplies include infusion sets, reservoirs, sensors, and test strips.
For more information on Medicare, please visit www.medicare.gov.
This is a Medicare DME benefit under Medicare Part B.
A Medtronic CGM is covered when used with an insulin pump system and specific criteria are met. The Guardian™ Connect CGM-only system will not be covered through Medicare because it does not have a durable receiver to meet Medicare benefit requirements. The CGM Access Discount program will still be available for qualifying individuals wanting Guardian™ Connect and who do not have coverage. Terms and conditions apply.
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, we can help.
