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Diabetic Services
Diabetes is a disease that is one of our most serious national health problems. The number of people who have diabetes or are at risk of becoming diabetic is increasing at a drastic rate.
The following is some recent information from The National Diabetes Fact Sheet released in January, 2011:
- 25.8 million children and adults in the U.S.—8.3% of the population have diabetes.
- Out of that number, 18.8 million people are diagnosed, and 7 million are undiagnosed.
- 79 million people are considered prediabetic—their blood glucose levels are higher than normal, but not yet high enough to be diagnosed diabetic.
- In 2010, 1.9 million new cases of diabetes were diagnosed in people 20 years of age and older.
What is Diabetes?
Diabetes is a group of diseases that causes your body to produce insufficient amounts of insulin or use it incorrectly. Insulin changes sugar, starches, and other food into the energy you need for your daily life. If your body’s blood glucose level is too high and left untreated, it can cause serious problems.
How is Diabetes Treated?
Depending on the type of diabetes you have, treatment involves some form (medication or injections) of supplying your body with the insulin it needs. Most people are able to manage the treatment of their diabetes with the right tools, diet, and medicine.
Types of Diabetes
There are several different types of diabetes.
- Type 1 diabetes: This form of diabetes is usually diagnosed in childhood or in young adults.
- Type 2 diabetes: This form of diabetes occurs in adults.
- Gestational diabetes: This form of diabetes occurs at around the 28th week of pregnancy. It usually doesn’t continue after you have your baby.
Diagnosing Diabetes
Because so many people have diabetes and don’t know it, it’s very important to be aware of the symptoms and be screened regularly. This is especially important if you have the risk factors that often predict who will get diabetes:
- You have a family history of diabetes
- You have dyslipidemia (a history of abnormal levels of cholesterol and triglycerides)
- You have high blood pressure
- You have a history of high blood sugar
- You are 65 or older
- You’re overweight
- You have a history of gestational diabetes
- You delivered a baby weighing over 9 pounds
Diabetes Screening
Fortunately, there is an accurate diabetes diagnostic and screening test, called Diabetes Screening (Fasting Plasma Glucose Test). This test measures the glucose levels in your blood after you have gone eight hours without eating.
Diabetes and Medicare Coverage
Medicare covers diabetes services and supplies that are related to diagnosing and treating diabetes. These services are covered under Part B of Original Medicare. If you have a Medicare Advantage Plan, the services should also be covered, but check with your specific plan to be sure.
What Does Medicare Cover?
- Testing: Medicare will cover up to two Diabetes Screenings per year if you have one of the following risk factors:
- Dyslipidemia
- Obesity
- High blood pressure
- History of high blood sugar
- You can be screened if you have two or more of the following risk factors:
- Age 65 or older
- Overweight
- Family history of diabetes
- History of gestational diabetes
- Diabetes Self-Management Training: “Self-Management Training” means that you can attend a program that teaches you how to manage your diabetes. It includes an overall education about the disease, how to monitor your blood glucose levels, your diet, exercise, and insulin. Medicare will cover up to 10 hours of training if you have met one of the following conditions in the last 12 months:
- You’ve been diagnosed with diabetes
- You’ve gone from no medication to taking diabetes medication, or you’ve gone from oral medicine to insulin
- You’ve had diabetes and just became eligible for Medicare
- You’re at risk for complications from diabetes
- You’ve had problems controlling your blood sugar, have been to an emergency room, or stayed overnight in a hospital
- You’ve been diagnosed with eye disease related to diabetes
- You’ve lacked feeling in your feet or had foot problems like ulcers, deformities, or an amputation
- You’ve been diagnosed with kidney disease related to diabetes
- Yearly Eye Exam: If you’ve been diagnosed with diabetic retinopathy.
- Foot Exam: You can have this twice a year if you have diabetic peripheral neuropathy (some loss of feeling) and loss of protective sensations.
- Glaucoma Screening: If you are at high risk for glaucoma, you can have a glaucoma screening once a year. Risks include:
- Being diabetic
- Have a family history of glaucoma
- African-American age 50 or older
- Diabetic Supply Products: Most of your diabetic supplies are covered under Medicare if you have diabetes and have a medical need for them.
Be Proactive
If you have a family history or are at risk for diabetes, carefully watch yourself for symptoms. For good preventative care, you should get screened, watch your diet, and exercise regularly.
If you have diabetes, learn how to take care of your disease and become comfortable with using the supplies that keep you healthy.
Diabetes is a very treatable condition and with the right life-management and medications, you can live a very normal life. But you must take care of yourself!
Be Informed
Be sure you understand your Medicare coverage for diabetes. It’s important that you follow all the guidelines. All doctors and providers must be Medicare-approved, and you must get your diabetes supplies from Medicare-certified suppliers. For more information on coverage for diabetes, go to www.Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
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