What does Medicare cover for diabetes?

Medicare does cover diabetes prevention, treatment, and supplies. The 2020 National Diabetes Report published by the CDC estimates the prevalence of diabetes. Among the US population in 2018, 34.2 million people of all ages (10.5%) had diabetes. However, adults with diabetes increased with age. The prevalence of seniors age 65 or older with diabetes is 26.8%. In other words, 1 out of 4 seniors has diabetes.

What does Medicare cover for diabetes - 1 in 4 seniors have diabetes in us

Type 2 Diabetes Prevention

You can prevent type 2 diabetes. The Havard school of public health says, “prediabetes and type 2 diabetes is largely preventable.” Moreover, lifestyle changes can lower your risk of developing type 2 diabetes. The Medicare Diabetes Prevention Program provides seniors with health behavior changes to help you prevent type 2 diabetes.

Diabetes Prevention Program

Medicare Part B covers a once in a lifetime diabetes prevention program. To qualify, you must meet all of the following conditions:

  • Test positive for Prediabetes within 12 months of your first meeting
  • Overweight: BMI of 25 or more (23 if Asian)
  • Never diagnosed with type 1 or 2 diabetes or ESRD
  • Never participated in the Medicare Diabetes Prevention Program

If you meet all of the above conditions, Medicare will pay for the diabetes prevention program. According to Medicare.gov, it “is a proven health behavior change program to help you prevent type 2 diabetes.” Moreover, the program includes 16 core sessions in a group setting for six months. Learn more about the benefits of this program.

What does Medicare cover for diabetes - prevention program seniors walking
Walking can reduce your risk of diabetes

Type 2 Diabetes Screening

Type 2 diabetes is a metabolic disease that results in high blood glucose levels. When your body does not produce enough insulin – a hormone that regulates sugar into your cells – or your body resists the effects of insulin, you have type 2 diabetes.

Since 1 in 4 seniors have type 2 diabetes and “often there are no symptoms” (WebMD), diabetes screening can help you avoid serious complications. Medicare pays for diabetes screening when you meet certain risk factors. Learn more about Medicare diabetes screening.

What does Medicare cover for diabetes - blood glucose meter
Blood glucose meter tests your blood sugar levels

Diabetes Self Management Education

Medicare Part B pays for Diabetes Self-Management Training (DSMT) when a doctor diagnoses you with diabetes. This diabetes self-management education includes one hour of individual training and nine hours of group training. Furthermore, you may be able to get DSMT services from a Registered Dietitian through Medicare Telehealth.

Discover what you pay for Diabetes Self Management Training and what you need from your doctor. Moreover, learn how diabetes self-management education can improve your blood glucose levels so you can reduce the onset and advancement of diabetes complications.

What does Medicare cover for diabetes - Diabetes Self Management Education

Medicare Diabetic Supplies

Medicare Part B covers blood sugar self-testing equipment and supplies. Discover which durable medical equipment (DME) Part B covers to test your blood glucose levels. Furthermore, learn which Medicare diabetic supplies Part D covers for the administration of insulin.

Diabetes Eye Care

If you have diabetes, Medicare Part B covers diabetic eye exams once a year. Furthermore, Part B also covers glaucoma tests every 12 months. Medicare pays 80% for this diagnostic eye care, and you must pay your Part B deductible of $203 in 2021. Moreover, you also have a copayment when you get these tests in an outpatient setting.

Diabetes Eye Care - eye exam chart

Diabetic Foot Care

If you have diabetes, Medicare Part B covers therapeutic shoes and inserts. Discover the question you need to ask your doctor and supplier before you order therapeutic shoes or inserts. Furthermore, learn which qualifying doctors can prescribe shoes and inserts for your diabetic foot care.

Diabetic Foot Care - shoe insert

Hyperbaric Oxygen Therapy

If you have type 1 or type 2 diabetes and have a lower extremity wound from diabetes, Medicare Part B covers Hyperbaric Oxygen (HBO) Therapy. During HBO therapy, you lay down inside a chamber with increased atmospheric pressure and oxygen. The increased supply of oxygen can help wounds heal. For example, HBO therapy helps heal diabetic foot wounds.

Medicare Part B pays 80% of HBO therapy, and you pay the remaining 20% and the Part B deductible of $203 in 2021. Since many HBO therapy treatments are needed to heal diabetic wounds, we recommend getting a Medicare Supplement such as Plan G.

Hyperbaric Oxygen Therapy - doctor communicates with senior inside chamber
Doctor communicates with senior inside a hyperbaric oxygen chamber.