Does Medicare Cover Ketone Test Strips? 

If you need to monitor your ketone levels, test strips can be a convenient and easy way to check. If your doctor suggests using ketone test strips due to a medical condition, or if you’re dieting and checking if you’re in ketosis, you may be wondering if your Medicare insurance will help cover the costs. 

If you have diabetes or another medical condition that puts you at risk for developing diabetic ketoacidosis (DKA), you may need to make sure your ketone levels are not too high. Your doctor may suggest using ketone test strips if you have diabetes and are having any symptoms of ketoacidosis, such as abdominal pain, nausea, and confusion.

Some people choose to monitor ketone levels due to a diet plan. If you are embarking on a keto diet or making any changes to your nutrition, you are encouraged to work with your doctor. The keto diet has become popular in recent years. In a nutshell, the keto diet is designed to send your body into a state of ketosis where fat is burned instead of glucose from carbohydrates. This diet has been shown to assist some seniors with weight loss, but many people also claim that eating a keto-friendly diet helps boost mood and energy. 

How do you know if you’re in ketosis?

One of the challenges seniors face when following a keto diet is knowing when their bodies are actually in a state of ketosis. Even if you follow the rules of a keto diet, which generally include limited carbs and high protein and healthy fats, it can be tough to know when your body is burning fat instead of glucose created by carbs.

To solve this, ketone test strips can be used. These are paper strips that are specially coated to detect the presence of ketones in the urine or blood. When these strips are exposed to ketones, they change color to let you know whether your body is burning ketones instead of glucose.

Does Medicare cover ketone test strips?

When following a ketogenic diet, using ketone test strips can help seniors maximize their exercise and eating habits by showing the times of day when exercise will have the greatest impact. Because seniors may go through a number of ketone test strips each day, it’s good to ask whether Medicare pays for these supplies.

Unfortunately, Medicare does not cover ketone test strips. These strips are viewed as lifestyle products, and while they may benefit your health, they generally are not considered a medical necessity. Original Medicare requires all covered items to be medically necessary in order to be eligible for benefits. Medical supplies and healthcare equipment related to diet and exercise generally fall outside of this definition.

Medicare coverage for diabetic testing supplies

Although Medicare coverage is not available for ketone test strips, the program does supply seniors with benefits for diabetic testing supplies, including test strips. Under Medicare Part B, Medicare recipients who are diabetic and take insulin can receive 300 test strips every three months with more available as required by your doctor.

If you do not take insulin and are diagnosed with diabetes, you can receive up to 100 test strips every three months. Medicare coverage is also available for additional diabetes testing and self-care supplies like lancets and syringes.

Medicare Part B requires you to meet a deductible and pay a monthly premium to utilize coverage. Additionally, the cost of medical equipment and supplies under Medicare Part B is shared between Medicare recipients and Medicare insurance. For blood glucose test strips, Medicare recipients pay 20% of the cost while Medicare insurance covers the remaining 80%.

Medicare Advantage plans may cover ketone test strips

If you’re a senior who is interested in eating a keto-friendly diet and would like to reduce your costs for test strips, it may be worth investigating Medicare Advantage plans in your area. These are insurance plans that include all of the benefits of Original Medicare, but plan providers have flexible options to include additional benefits.

You may be able to find a provider that offers benefits for over the counter products, including ketone test strips, or a reimbursement program or manufacturer coupons for certain brands of ketone test strips that can be purchased from local pharmacies. Many Medicare Advantage plans also offer access to fitness programs like SilverSneakers.

SilverSneakers is a program designed especially for seniors who want to lose weight and get in shape. Because each state has varying regulations regarding what Medicare Advantage plan providers can offer, you can contact an independent Medicare Advantage plan broker to learn your options.