Medicare Coverage and Costs for Diabetes Medications Including Metformin

Medicare provides extensive coverage for diabetes treatments and related medical supplies across its different parts. This includes Original Medicare (Part A and Part B), Medicare Advantage (Part C), and Medicare Part D which specifically covers antidiabetic drugs like Metformin, insulin, and various diabetic supplies. Metformin, approved by the FDA in 1994, is widely used for managing type 2 diabetes and is the only medication currently recommended for prediabetes by the American Diabetes Association.

Medicare Part D plans, offered by Medicare-approved private insurers, include various cost components impacting out-of-pocket expenses for beneficiaries. These costs encompass monthly premiums, deductibles (capped at $590 in 2025), copayments, and coinsurance. Once a beneficiary’s annual drug costs hit $2,000, they qualify for catastrophic coverage where medication costs are fully covered for the remainder of the year.