Diabetes Prevention Program Medicare covers a once-per-lifetime health behavior change program to help you prevent type 2 diabetes. The program begins with weekly core sessions in a group setting over a 6-month period. In these sessions, you’ll get:
• Training to make realistic, lasting behavior changes around diet and exercise.
• Tips on how to get more exercise.
• Strategies to control your weight.
• A specially trained coach to help keep you motivated.
• Support from people with similar goals and challenges.
Find out if Medicare covers your test, item, or service 37 Once you complete the core sessions, you’ll get:
• 6 monthly follow-up sessions to help you maintain healthy habits.
• An additional 12 monthly ongoing maintenance sessions if you meet certain weight loss and attendance goals. To be eligible, you must have:
• Medicare Part B (or a Medicare Advantage Plan).
• A fasting plasma glucose of 110-125mg/dL, a 2-hour plasma glucose of 140–199 mg/dL (oral glucose tolerance test), or a hemoglobin A1c test result between 5.7 and 6.4% within 12 months prior to attending the first core session.
• A body mass index (BMI) of 25 or more (BMI of 23 or more if you’re Asian).
• Never been diagnosed with type 1 or type 2 diabetes, or End-Stage Renal Disease (ESRD).
Never participated in the Medicare Diabetes Prevention Program. You pay nothing for these services if eligible. Visit Medicare.gov/contacts to see if there’s a Medicare Diabetes Prevention Program supplier in your area. Diabetes screenings Medicare covers up to 2 glucose laboratory test screenings (with and without a carbohydrate challenge) each year if your doctor determines you’re at risk for developing diabetes. You pay nothing for the test if your doctor or other qualified health care provider accepts assignment. Diabetes self-management training Medicare covers diabetes outpatient self-management training to teach you to cope with and manage your diabetes. The program may include tips for eating healthy, being active, monitoring blood sugar, taking medicine, and reducing risks. Some patients may also be eligible for medical nutrition therapy training. You must have diabetes and a written order from your doctor or other qualified health care provider who’s treating your diabetes. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
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