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What is the Medicare Diabetes Prevention Program?

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Summary: Diabetes prevention can help avoid many serious health problems, and even death, according to the Cleveland Clinic.

Why is diabetes prevention important?

Before going into diabetes prevention, here’s a quick overview about the disease itself.

The American Diabetes Association explains that diabetes is a disease that causes blood sugar levels to rise higher than normal. Diabetes can damage your kidneys, nerves, heart, and eyes. Not only that, but diabetes can even affect your brain and blood vessels, and cause and neuropathy of the feet.

According to the Centers for Medicare & Medicaid Services (CMS), more than 25% of Americans age 65 and older are affected by diabetes, with type 2 diabetes the most common form. It’s a common and sometimes avoidable disease, so diabetes prevention is important.

Medicare launched the Medicare diabetes prevention program in 2018. The Medicare Diabetes Prevention Program is a partnership between Medicare and private organizations. The program teaches people about diabetes and coaches you about lifestyle changes. You might qualify for the program if you’re at risk for type 2 diabetes.

What is the Medicare diabetes prevention program?

The Medicare diabetes prevention program starts with at least 16 training sessions over 6 months. These classes teach you how to make healthy behavior changes to help prevent or delay getting diabetes. The training includes:

  • Lifestyle coaching to help you stay motivated
  • Weight control tips
  • Exercise tips
  • Group support from people with similar challenges and goals

After you take these diabetes prevention training sessions, you may be able to keep taking monthly sessions to help you continue what you learned.

Medicare offers the diabetes prevention program free of charge to eligible people under Medicare Part B.

Who can get the Medicare diabetes prevention program?

To participate in the Medicare diabetes prevention program, you must be enrolled in Medicare Part B or a Medicare Advantage plan. You generally have to meet these requirements as well:

  • You must have a blood test that shows you have “prediabetes” within a year before going to the first session.
  • You must have a body mass index (BMI) of 25 or more (BMI of 23 or more if you’re Asian).
  • You can’t already be diagnosed with type 1 or type 2 diabetes, or End-Stage Renal Disease.
  • This must be your first time signing up for the Medicare diabetes prevention program. This diabetes prevention program is a one-time benefit.

Talk with your doctor if you think you may benefit from Medicare’s diabetes prevention program. You may need a blood test to determine if you are at risk for diabetes.

Does Medicare cover diabetes treatment and supplies?

Even if you have diabetes and don’t qualify for the Medicare diabetes prevention program, Medicare Part B may cover some supplies and services for you. Medicare Part B may cover these diabetes treatment services and supplies:

  • Blood sugar testing monitors and test strips
  • Insulin
  • Lancet devices and lancets
  • Therapeutic shoes or inserts
  • Diabetes self-management training
  • Yearly eye exam
  • Foot exam
  • Glaucoma tests
  • Nutrition therapy services

If you have a Medicare Advantage plan, it will cover the Medicare diabetes prevention program and the diabetes supplies listed above if you qualify.

Look for Medicare Advantage plans in your vicinity anytime it’s convenient for you. Enter your zip code on this page to begin.

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