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Certain Medicare Part D prescription drug plans and Medicare Advantage plans (Part C) that include Medicare covers many diabetes treatments, but coverage for insulin pens and supplies can vary depending on the type of plan you choose. Here’s how it works in 2025.

Medicare Part B Coverage

Part B generally does not cover insulin pens, but it does cover certain diabetes supplies and services, including:

• Blood sugar test strips and monitors
• Lancets and lancet devices
• Glucose control solutions
• Diabetes self-management training
• Annual eye and foot exams
• Medical nutrition therapy

If an insulin pump is deemed medically necessary, Part B may cover both the pump and the insulin used with it. After meeting your $257 Part B deductible (2025), you typically pay 20% coinsurance. Medigap plans can help cover these out-of-pocket costs.

Medicare Part D & Medicare Advantage Coverage

Part D drug plans and Medicare Advantage plans usually provide coverage for:

• Injectable and inhaled insulin (not used with a pump)
• Insulin pens
• Supplies like needles, syringes, and alcohol swabs
• Other anti-diabetic medications

Each plan has its own formulary (list of covered drugs). Your costs depend on:

• The specific medication prescribed
• Your plan’s formulary and rules
• Whether you use in-network pharmacies
• If you qualify for Extra Help with Part D costs

What Medigap Covers

Medigap plans do not pay for insulin or supplies directly, but they help with Medicare’s deductibles, coinsurance, and copayments. This makes your costs for diabetes care more predictable.

Bottom Line

Original Medicare alone does not cover insulin pens. To get coverage, you’ll need a Part D prescription drug plan or a Medicare Advantage plan that includes drug benefits. Medigap can help reduce your out-of-pocket costs for the Part B services you rely on for diabetes management.

Compare Medicare drug and supplement plans to find the right coverage for your insulin and supplies.

Mental health matters, and Medicare provides coverage for therapy, medications, and preventive services to help beneficiaries manage conditions like depression and anxiety.

Medicare Part A: Inpatient Mental Health Care

Part A covers inpatient treatment in hospitals and psychiatric facilities. Key points:

• Covers room, nursing care, therapy, tests, and medications during an inpatient stay.
• Lifetime limit of 190 days in a psychiatric hospital, but no limit in general hospitals.
• 2025 costs: $1,676 deductible per benefit period, $419/day coinsurance for days 61–90, $838/day for lifetime reserve days.

Medigap plans can cover some or all of these costs, including the Part A deductible.

Medicare Part B: Outpatient Mental Health Services

Part B helps with ongoing therapy and outpatient care, including:

• Individual and group counseling
• Annual depression and alcohol misuse screenings
• Psychiatric evaluations and lab tests
• Visits with psychologists, psychiatrists, social workers, and licensed counselors

2025 costs: $257 annual deductible, then 20% coinsurance per service. Medigap can help cover these copays.

Medicare Part D: Mental Health Medications

All Part D drug plans cover FDA-approved antidepressants, antipsychotics, anti-anxiety drugs, and mood stabilizers, including generics. Copays depend on the plan’s drug formulary and tier system. Learn more about drug coverage.

Medicare Advantage (Part C)

Medicare Advantage plans include the same mental health coverage as Parts A and B, usually with bundled drug coverage. Some plans add extra benefits like vision or dental. Remember: you cannot have both Medicare Advantage and Medigap at the same time.

How Medigap Helps

Medigap can protect you from the high out-of-pocket costs of mental health treatment. Plans typically cover:

• Part A deductibles and inpatient coinsurance
• Part B coinsurance for therapy visits
• Extra hospital coverage beyond lifetime reserve days

With Medigap, your mental health care becomes more predictable, allowing you to focus on recovery instead of bills. Compare Medigap plans to see whic

Medicare Part A benefit periods can be confusing, and many beneficiaries are surprised to learn they may face more than one deductible in a single year. Here’s what you need to know.

How Medicare Part A Benefit Periods Work

Unlike private insurance, Medicare Part A does not use annual benefit periods. Instead:

• A benefit period begins the day you are admitted to a hospital or skilled nursing facility.
• It ends when you’ve been out of the hospital for at least 60 days.
• If you’re readmitted after 60+ days, a new benefit period begins — and you’ll pay a new deductible.

Costs in 2025

• Deductible: $1,632 per benefit period.
• Days 1–60: $0 after deductible.
• Days 61–90: $408 per day.
• Days 91+: $816 per day using lifetime reserve days (you only get 60 total).
• After reserve days are used, you pay all costs.

Example Scenario

Meet Helen, age 67. She is hospitalized twice in one year, more than 60 days apart. Because a new benefit period started, she had to pay the Part A deductible both times — and coinsurance for days past 60. Without additional coverage, these costs can add up quickly.

How Medigap Can Help

Medicare Supplement Insurance (Medigap) can reduce or eliminate these out-of-pocket costs:

• All Medigap plans cover your Part A coinsurance, plus an extra 365 days of hospital coverage after lifetime reserve days are used.
• Most Medigap plans also cover part or all of the Part A deductible.

Compare Medigap plans to see how you can avoid paying multiple deductibles in the same year.

Medicare Part B does more than cover doctor visits and medical services — it also provides important preventive care that many beneficiaries overlook. Taking advantage of these benefits can help you stay healthier and avoid higher costs later.

10 Often-Overlooked Medicare Part B Benefits

• Welcome to Medicare Visit – One-time preventive appointment in your first 12 months of Part B coverage.
• Annual Wellness Visit – A yearly check-up to update your personalized care plan.
• Alcohol Misuse Screening – Covered annually, with up to four counseling sessions if needed.
• Mammograms – Annual screenings for women 40+, plus baseline coverage for women 35–39.
• Depression Screening – One covered screening per year in a primary care setting.
• Glaucoma Test – Annual test for those at higher risk, such as people with diabetes or family history.
• Bone Density Test – Covered every 24 months for those at risk of osteoporosis.
• Obesity Counseling – Regular counseling sessions for individuals with a BMI of 30 or higher.
• Nutrition Therapy – For beneficiaries with diabetes, kidney disease, or post-kidney transplant.
• Tobacco Cessation Counseling – Up to 8 sessions per year to help quit smoking.

The best part? Many of these services are covered at 100% of the Medicare-approved amount when provided by a participating provider. Learn more about Medicare Part B benefits and how Medigap plans can help with your out-of-pocket costs.

Medicare Part D provides coverage for prescription drugs, helping millions of beneficiaries manage their medication costs. In 2025, you can choose a standalone Part D plan or enroll in a Medicare Advantage plan that includes drug benefits.

What Is Medicare Part D?

Medicare Part D, also known as prescription drug coverage, is optional and offered by private insurance companies. It’s important to note that Medigap Plan D is a completely different product and does not cover prescription drugs.

Ways to Get Prescription Drug Coverage

• Standalone Part D plan (PDP) – Works with Original Medicare (Part A and Part B), with or without a Medigap plan.
• Medicare Advantage Prescription Drug Plan (MAPD) – Bundles medical and drug coverage together.

Drug Formularies and Tiers

Every Part D plan has a formulary (list of covered medications) arranged into cost tiers:

• Tier 1 – Low-cost generics with small copayments.
• Higher tiers – Brand-name or specialty drugs with higher copayments or coinsurance.

Plans may also offer preferred pharmacies with discounted pricing.

Costs in 2025

• Premiums – The average monthly premium is $46.50, but costs vary by carrier and coverage.
• Deductibles – Up to $590, though some plans have $0 deductibles.
• Copayments & Coinsurance – Based on the drug tier and pharmacy choice.

High-income beneficiaries may also pay an IRMAA surcharge. Learn more about IRMAA.

Enrollment Periods

• Initial Enrollment Period (IEP) – The 7-month window around your 65th birthday.
• Annual Enrollment Period (AEP) – October 15 to December 7 each year; join, drop, or switch plans.
• Special Enrollment Periods (SEP) – Available if you lose creditable coverage or move outside your plan’s service area.

If you go without creditable prescription coverage for 63+ days, you may face a permanent Part D late enrollment penalty.

New for 2025: $2,000 Out-of-Pocket Cap

Starting in 2025, once your out-of-pocket drug costs reach $2,000, you will not pay anything more for covered prescriptions that year. This replaces the old “donut hole” coverage gap, making drug costs more predictable.

Bottom line: Medicare Part D can protect you from high prescription drug costs, but plans vary in coverage and price. Compare formularies, premiums, and pharmacy networks to find the plan that works best for your needs. Compare Medicare drug plans today.

Navigating Medicare can be confusing, and even small mistakes can lead to costly lifelong penalties or gaps in coverage. Below are 10 of the most common errors and guidance on how to avoid them.

1. Choosing the Wrong Medicare Path

As a beneficiary, you have two main ways to receive benefits:

• Original Medicare (Part A and Part B) – Government-managed coverage. You can add a Medicare Supplement Insurance (Medigap) policy to help pay for deductibles, coinsurance, and copayments, plus a Part D Prescription Drug Plan for medication coverage.
• Medicare Advantage (Part C) – Offered by private insurers. These plans include Part A and B benefits and may bundle extra features like prescription drugs, dental, vision, and hearing.

Learn more about Medicare basics.

2. Assuming You’re Automatically Enrolled

Some people are enrolled in Medicare automatically at 65, but many are not. You will be automatically enrolled in Part A and Part B only if:

• You already receive Social Security or Railroad Retirement Board benefits.
• You’ve received disability benefits for at least 24 months.
• You have ALS (Lou Gehrig’s disease).

If you do not receive your Medicare card by mail, you must apply manually through the Social Security Administration. See Medicare eligibility and enrollment rules.

3. Missing Your Initial Enrollment Period

Failing to enroll at the right time can lead to permanent penalties. For Medicare Part B, your premium increases 10% for every 12 months you were eligible but not enrolled. Your Initial Enrollment Period (IEP) runs for 7 months around your 65th birthday.

If you’re still working and covered by employer insurance, confirm that your coverage is “creditable” to avoid penalties later. Otherwise, plan to enroll during your IEP. If you miss it, you may need to wait until the General Enrollment Period (Jan 1 – Mar 31), and your coverage won’t begin until July 1.

Learn more about Special Enrollment Periods.

4. Overestimating COBRA or Retiree Coverage

COBRA or retiree benefits do not count as primary coverage after age 65. If you rely on them without enrolling in Medicare Part B, you may face late penalties and gaps in coverage. Always confirm whether your employer plan qualifies as creditable coverage before delaying Medicare.

5. Overlooking Prescription Drug Coverage

Original Medicare offers limited prescription coverage. To avoid costly gaps, most beneficiaries add a Part D plan for medication costs. Medicare Advantage plans often include drug coverage, but Original Medicare requires a separate Part D policy.

6. Underestimating Out-of-Pocket Costs

Original Medicare does not cover all services. You’re still responsible for premiums, deductibles, copayments, coinsurance, and services like excess charges. It also does not cover dental, vision, hearing, or long-term care. Learn more about Medicare out-of-pocket costs.

7. Confusing Medigap with Medicare Advantage

You cannot have both at the same time.

• Medigap plans supplement Original Medicare, covering many out-of-pocket expenses. There are 10 standardized plans available in most states.
• Medicare Advantage replaces Original Medicare with a private plan that includes Part A and Part B benefits, and often prescription drugs, dental, vision, or hearing.

Compare Medigap vs. Medicare Advantage.

8. Assuming Spouses Can Share Coverage

Each spouse needs their own Medigap policy. Some insurers may offer small spousal discounts, but Medigap coverage is always individual. Be sure to ask insurers about discounts if you and your spouse apply together. Find a Medigap policy.

9. Not Exploring Financial Assistance

If Medicare costs are overwhelming, programs may help:

• Extra Help – Reduces prescription drug costs.
• Medicare Savings Programs – May cover Part A or Part B premiums.
• Medicaid – For those with very limited income and resources.
• PACE – Community-based care for seniors who qualify.

Learn more about Medicare cost assistance.

10. Missing Your Medigap Open Enrollment Period

Your best time to buy a Medigap plan is during your 6-month Open Enrollment Period (OEP). This begins when you are 65 or older and enrolled in Medicare Part B. During this window:

• Insurers cannot deny coverage or charge more due to health status.
• You can switch plans freely.
• Coverage begins right away (with limited exceptions for pre-existing conditions).

If you wait, you could be denied coverage or pay higher premiums. Learn more about Medigap Open Enrollment.

Bottom line: Avoiding these 10 mistakes can save you money, prevent penalties, and ensure that your Medicare coverage meets your health care needs. Always compare your options carefully, and consider seeking expert guidance before enrolling.