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 diabetes self-management training if you meet one of the following conditions during the last 12 months:

You were diagnosed with diabetes
You changed from having no diabetes medication to taking diabetes medication, or yo changed from oral diabetes medication to insulin
You have had diabetes and just recently become eligible for Medicare
You’re at risk for complications from diabetes, if you have any of the following:
- Problems controlling your blood sugar, and have been treated in an emergency room, or have stayed overnight in a hospital
- Been diagnosed with eye disease related to diabetes
- Have a lack of feeling in your feet or some other foot problems like ulcers, deformities, or have had an amputation
- Been diagnosed with kidney disease related to diabetes

Your doctor will give you information about where to get diabetes self-management training. You must get this training from a certified diabetes self-management education program.

Medicare will cover a total of 10 hours of initial training within a continuous 12-month period, and 2 hours of follow-up training each year after that

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.

These services include:

Nutrition and lifestyle assessment
Nutrition counseling (what foods to eat and how to follow an individualized plan)
How to manage lifestyle factors
Follow-up visits to check on your progress

The first year, Medicare covers three hours of one-on-one medical nutrition therapy services. Each year after that, you are eligible for two hours of nutrition therapy.

How Much Will I Pay?

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

You must pay your annual 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. Each year, your doctor must prescribe these services for Medicare to pay for them.
If your diabetes self-management training is in an outpatient facility it will be covered under Medicare Part A.

See Related Topics

If you have diabetes, Medicare might cover some or all of the cost of the following when qualified. Click on any topic below to learn more:

Equipment and Supplies

Services and Procedures

Coverage Topics

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