I've been diagnosed with prediabetes. What preventive services does Medicare cover to help prevent progression to type 2 diabetes?
Answered by 10 licensed agents
Preventive care is not done on the bases of your medicare but on the quality of care from your doctor. A good doctor will provide good care and education to prevent progression of illness. Depending on your insurance and dietary needs set by your physiscian, you can utilize benefits like nutrition health as well as gym memberships to support a good healthy habit which are typically included with your coverage.
Its always a tough when you hear about any diagnosis from a Health Care professional regarding Diabetes. If you watch the news at all, you know that any Diabetes related health condition is serious and effects a large part of our population. Medicare provides several "Preventive Services'" that come at low or no Out of Pockets costs. Medicare Diabetes Prevention Program (MDPP) is a comprehensive One Time health behavior change program is available to help you prevent Type II diabetes. Common services like Diabetes Screening and monitoring, Medical Nutrition, foot exams and Hemoglobin A1C, Glaucoma Screenings as well as "Welcome to Medicare" preventive visits are design to address your diagnosis and prevent it from getting worse! Your Medicare agent can educate you on what is available to you! If you are new to Medicare you will love it!
Medicare covers the Pre-diabetes program once in your lifetime. But, you must meet all 12 conditions to be covered. Part B will pay for the full costs associated with this treatment, should you qualify. This is a behavioral program only.
The Medicare Diabetes Prevention Program begins with up to 16 weekly group sessions over a 6-month period. You can choose to attend sessions in person, virtually, or both. This is provided as a one-time benefit. Nutrition services (professional) are not provided.
Medicare covers insulin and a variety of antidiabetic drugs. Original Medicare (parts A and B) and Medicare Advantage (part C) cover insulin administered via a pump and certain diabetes supplies.
Medicare prescription drug coverage provides comprehensive coverage for diabetes medications. Reach out to me or an agent in your area for more information. Also, Medicare.gov is a great resource.
All types of diabetic screenings/educational trainings are typically falling under the title of “preventive care”. All preventive care is typically free of charge, but there are quantity and some limitations. That’s something you would want to talk to an agent or broker about to get more detailed information on that’s because it’s also impacted by what plan you have and what carrier you have and where you live, along with what type of screening are they wanting to do. All of these things have to be taken into consideration. Mostly speaking, all preventive care is typically zero charge to the client.
Keep in mind if you have a Medicare advantage, you will have to have a prior authorization approved before you can go get that done and with original Medicare and Medicare supplements you have no prior authorizations.
Under Original Medicare (Part A and B), a person has access to Diabetes Screening and Diabetic Counseling that may include diabetes prevention and education. Some Medicare Supplements (Medi-Gap) and Medicare Advantage Plans offer "0" cost gym memberships included, which may help prevent full diabetes.