Medicare Diabetes Screening

Type 2 Diabetes

In this MedicareBob video, Robert Bache shows you diabetes type 2 warning signs and how Medicare diabetes screenings can help you avoid serious health issues. For example, screening may help people avoid long-term damage to the eyes, kidneys, nerves, heart, and blood vessels. Furthermore, webmd.com says, “people with undiagnosed type 2 diabetes have a significantly higher risk for stroke, coronary heart disease, and peripheral vascular disease.”

Robert says you can get the diabetes screenings every two years. However, Robert misspoke. The video’s graphic shows, “you may be eligible for two diabetes screenings each year.”

What is Type 2 Diabetes?

Type 2 diabetes is a metabolic disease and the most common form of diabetes. According to Medicinenet.com, people with type 2 diabetes have high blood sugar (glucose). In a healthy person, insulin controls your blood glucose levels. For example, you eat carbohydrates, and your blood glucose levels rise. Then your pancreas releases insulin to normalize your blood’s glucose level. 

However, a person with type 2 diabetes eats carbohydrates, and their pancreas produces an inadequate amount of insulin to normalize glucose levels. Consequently, the person gets high blood sugar, also called hyperglycemia. Alternatively, the Mayoclinic.org says, “with type 2 diabetes, the body resists the effects of insulin – a hormone that regulates sugar’s movement into your cells.” 

Medicare Diabetes Screening - blood glucose meter

Blood Glucose Meter tests your blood sugar levels

Free Medicare Diabetes Screening

According to Medicare.gov, it costs you nothing for Medicare diabetes screening when your doctor determines you are at risk for diabetes or diagnosed with pre-diabetes. You can get free lab tests two times per year if you have any of the following diabetes risk factors:

  • High blood pressure (hypertension)
  • History of abnormal cholesterol and triglyceride levels (dyslipidemia)
  • Obesity: BMI of 30 or greater
  • A history of high blood sugar (glucose)

Furthermore, Medicare pays for two diabetes screenings per calendar year if two or more of the following pre-diabetes conditions apply to you:

  • Age: 65 or older
  • Overweight: BMI over 25 and less than 30
  • Family History: your parents or siblings have diabetes
  • Pregnancy History: you have a history of diabetes during pregnancy, also called gestational diabetes
  • Heavy Baby: you delivered a baby weighing more than 9 pounds

Moreover, according to CMS, if a doctor diagnoses you with pre-diabetes, your screenings must be at least six months apart. However, if you were previously tested but not diagnosed with pre-diabetes, or this is your first test, you are eligible for one diabetes screening test per year. 

Diabetes Screening Tests

The most common Medicare diabetes screening is a fasting plasma glucose test (FPG) followed by a 2-hour glucose tolerance test. The FPG test measures your blood sugar level after fasting, not eating or drinking (except water, tea, black coffee – no sugar) for at least 8 hours. According to CMS definitions, you have pre-diabetes when your fasting blood glucose is 100 to 125 mg/dL. Moreover, you have diabetes when your fasting blood glucose is 126 mg/dL or greater on two different occasions.

After the doctor takes a sample of your blood to measure your fasting blood glucose level, you drink a glucose solution that contains 75 grams of sugar. Then after two hours, your blood is tested. According to Mayoclinic.org, a normal blood glucose level is lower than 140 mg/dL. You have pre-diabetes with a blood glucose level between 140 and 199 mg/dL. Finally, you have diabetes with a blood glucose level of 200 mg/dL or higher.

If you test positive for diabetes, Medicare pays for a second screening to confirm the diagnosis.

Medicare Diabetes Screening - Glucose Tolerance Drink

What else does Medicare cover for diabetes?

In addition to diabetes screening, Medicare covers the following:

To help you decide which Medicare services are most relevant to you, read the informative summary of what Medicare covers for diabetes.

Medicare Diabetes Screening - happy senior couple