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Diabetic Services

Which Diabetic Related Services Does Medicare Cover?

Medicare covers many services related to the treatment of diabetes.

Diabetes Screening (Fasting Plasma Glucose Test):
Medicare Part B does cover tests to check for diabetes. These tests are covered only if you have one or more of the following risk factors:

• Dyslipidemia (History of abnormal cholesterol and triglyceride levels)
• Obesity
• High blood pressure
• History of high blood sugar

Or if you have two or more of the following risk factors:

• You are age 65 or older
• You are overweight
• You have a family history of diabetes
• You have a history of gestational diabetes (diabetes during pregnancy)
• You have delivered a baby weighing more than 9 pounds

Based on the results of these tests, you may be eligible for up to two diabetes screenings every year.

Yearly Eye Exam:

Medicare covers yearly eye exams for diabetic retinopathy.

Diabetes Self-Management Training:

Diabetes outpatient self-management training is a program to teach you how to manage your diabetes and is covered by Medicare Part B. This program should include an overall education of diabetes including how to monitor your blood glucose levels. It also includes education about diet, exercise and insulin.

Medicare will cover up to ten hours of initial training if you have been diagnosed with diabetes. You may also qualify for an additional two hours of annual follow up training if:

• The training lasts for at least 30 minutes
• Your doctor orders the training as part of your care plan
• The training takes place within the 1^st calendar year of your initial training
• The training is provided in a group of 2 to 20 people. Some exceptions to group size may be made if your doctor confirms that you have special needs that prevent you from training within a group.

Foot Exam:

Twice a year people with diabetic peripheral neuropathy and loss of protective sensations can receive a foot exam as long as they have not seen a foot care professional for another reason between visits.

Glaucoma Screening:

Once every 12 months Medicare will cover a glaucoma screening for people at high-risk for glaucoma. High risk candidates include people with diabetes, people with a family history of glaucoma or African-Americans who are age 50 and older. Glaucoma screenings must be done by, or supervised by, an eye doctor who is legally permitted to perform the screening in your state.

Medical Nutrition Therapy Services:

People who are referred by their doctor and have diabetes or kidney disease can receive medical nutrition therapy covered under Medicare. These services can be given by a registered dietician or Medicare-approved nutrition professional and include nutritional assessment and counseling to help you mange your diabetes or kidney disease.

How Much Will I Pay?

You pay for 20% of the Medicare approved amount under Medicare Part B.

You pay nothing for the diabetes Screening.

You must pay a $135 deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. If a doctor, health care provider or supplier does not accept assignment; the amount you pay may be higher.
If your diabetes self-management training is in an outpatient facility it will be covered under Medicare Part A.

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