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What Medicare Covers for Diabetics Dealing with Chronic Pain

September 2018

Living with diabetes often involves more than just a change in diet and regular glucose testing. Diabetic individuals in the United States often experience a wide variety of complications that have a significant impact on daily life. One of the most impactful (and frequently misunderstood) issues that many people deal with is chronic pain, often caused by neuropathy.

Those who are experiencing chronic pain with diabetes often have several questions: How do I manage these pain issues while still living my life to the fullest? What treatment options are available to me? What does Medicare or my insurance company cover to treat?

We are here to help clarify how people with diabetes can use their Medicare coverage to live their best lives when faced with chronic nerve pain.

Why is chronic pain common in people with diabetes?

Chronic pain is defined as moderate to severe pain that is felt on a daily basis and continues for over six months. Statistically, people with diabetes are more susceptible to long-term pain than those without the diagnosis. Not all nerve pain has the same root cause, however. Here are some of the reasons a person with diabetes may be dealing with this issue:

  • Neuropathy. This is a common complication of diabetes that can include pain and numbness in the back, feet or hands.
  • Arthritis. Type 2 diabetes and arthritis both disproportionately affect people who are older, making the combination fairly common among aging Americans.
  • Fibromyalgia and pain conditions. While these conditions may not be directly linked to diabetes, chronic pain disorders combined with diabetic neuropathy can exacerbate the challenges people face.

What can I do to manage my chronic pain with diabetes?

Prescription medications are often the first thing discussed when it comes to treating chronic pain, but many different and non-drug treatment options can  help support an effective treatment plan. Luckily, Medicare covers many of these things.

For a full list of items covered by Medicare for people with diabetes, click here.

1) Use a Transcutaneous Electrical Nerve Stimulator (TENS Therapy)

freedom tens unit covered by medicare for diabetes chronic pain

TENS therapy uses small electrical impulses to block pain signals and increase endorphins. It is recommended by many pain management professionals as a non-invasive, non-painful and non-surgical way to treat neuropathy and similar conditions.

Besides its effectiveness, this treatment is used by many people with chronic pain because it is easy to do from the comfort of  home. The FREEDOM TENS Unit is a device that people can keep on hand to respond to pain flare-ups. It comes with four modes (Burst, Normal, Pulse Width Modulation, Pulse Rate Modulation) allow users to modify the treatment depending on what works for them.

How to get it a TENS unit covered by Medicare: Talk to your doctor to get a signed “durable medical equipment” prescription for a TENS unit. You will need to meet certain standards in order to be approved for coverage, including the verifying that the pain is chronic (3 months or longer). Medicare will typically cover a 30 to 60 day rental of the unit to start, then allow people to move onto a full purchase if the treatment is successful. For more information on the paperwork needed and how to rent or buy a TENS unit, contact Quantum Medical Supply at 1-866-923-2423.

2) Wear the right shoes and inserts.

If you are feeling chronic pain in your feet, ankles, legs or even hips, there is some relief available: Medicare covers one pair of therapeutic shoes and three pairs of inserts for qualifying people each year. Even if the pain has not reached your feet, diabetic shoes can play an important role in protecting from future damage.

How to get diabetic shoes and inserts covered by Medicare: To obtain coverage, your doctor will need to fill out both a Certificate of Medical Necessity and a Shoe Prescription. The shoe prescription can also come from a podiatrist or nurse practitioner. Your shoes will also need to be professionally fitted and ordered your shoes from a Medicare-approved supplier. Some, like nocostshoes.com, are even able to directly bill your insurance company. To see if you qualify, click here to fill out our application.

3) Get back, knee, ankle and/or wrist braces.

Braces are commonly recommended by doctors and physiotherapists to reduce pain from free-moving joints. There are specific types of braces that may be more beneficial for long-term use by someone with chronic pain; for example, this product from TemCare Pro uses an air pump system to help people customize the compression for added comfort.

How to get diabetic shoes and inserts covered by Medicare: Like shoe coverage, a certificate of medical necessity and qualifying diagnosis is needed to get coverage for these items. For more details on what is available and the documents needed for coverage, call 866-923-2423.

4) Control your blood sugar using a continuous glucose monitor (CGM).

Managing blood sugar should be at the top of your list if you’re dealing with any symptoms of diabetes, including chronic pain from neuropathy. Medicare covers various blood sugar/glucose testing aids including test strips, syringes, and insulin pumps. One of the most exciting and often lesser known things Medicare covers for glucose management is a continuous glucose monitor or CGM.

Continuous glucose monitors like the Dexcom G6 are an easy-to-use alternative to a finger prick blood sugar test. Using a small sensor placed below the skin, it keeps an eye on glucose on an ongoing basis. This can improve the accuracy of readings and remove the discomfort of a traditional test. Best of all, this technology is free or deeply subsidized for people with Medicare and certain insurance plans!