Dante Carrillo
Medicare Part B covers nutrition counseling for people with diabetes and kidney disease, including those who have had a kidney transplant within the last 36 months. This includes free dietitian visits and medical nutrition therapy services, which can help individuals with diabetes to manage their condition and prevent complications. Medicare also covers weight-loss counseling by a primary care provider to help increase exercise, change diet, and control weight. Additionally, Medicare Part B covers the Medicare Diabetes Prevention Program once in a person's lifetime, which offers 16 weekly core sessions over a 6-month period to help prevent type 2 diabetes.
| Characteristics | Values |
|---|---|
| Medicare Part covering diabetes counseling and diet | Part B (Medical Insurance) |
| Coverage | Medical nutrition therapy services for diabetes and kidney disease or kidney transplant in the last 36 months. |
| Referral | Required by a doctor |
| Coverage for dialysis patients | Medical nutrition therapy services are covered as part of dialysis care. |
| Coverage for prediabetes | Medicare Diabetes Prevention Program (MDPP) is covered once in a lifetime. |
| Coverage for weight-loss counseling | Covered by Medicare Part B for people with a BMI of 30 or higher |
| Coverage for cholesterol medications | Covered by Medicare Part D |
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What You'll Learn
Medicare Part B covers diabetes counselling
To qualify for this service, you must have diabetes or kidney disease, or have had a kidney transplant within the last 36 months. A doctor must refer you for these services, and you may receive up to three hours of initial coverage in the first calendar year. If your doctor decides that a change in your medical condition requires a change in your diet, they can refer you for more hours beyond the initial coverage. You may get up to two hours of follow-up services each calendar year, after the year you got your initial coverage.
Medicare Part B also covers weight-loss counselling by a primary care provider to help you lose weight through diet and exercise. To qualify, you must have a body mass index (BMI) of 25 or higher (23 or higher if you're Asian) and meet certain blood sugar test requirements. The program includes an initial obesity screening, dietary assessment, and behavioural therapy.
Medicare Part B also covers the Medicare Diabetes Prevention Program once in your lifetime if you meet certain conditions. To qualify, you must have a BMI of 25 or more (23 or more if you're Asian), never been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD), and never participated in the program before. The program begins with 16 weekly core sessions offered in a group setting over a six-month period, followed by monthly follow-up sessions for another six months.
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Medicare Diabetes Prevention Program
Medicare Part B covers the Medicare Diabetes Prevention Program (MDPP) once in a lifetime for eligible individuals. The MDPP is a health behaviour change program that helps prevent type 2 diabetes. It is a structured intervention program that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with prediabetes.
To qualify for the program, you must meet the following criteria within 12 months before attending your first core session:
- Have a body mass index (BMI) of 25 or more (BMI of 23 or more if you're Asian)
- Have never been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD)
- Have never participated in the Medicare Diabetes Prevention Program before
The program consists of 16 weekly core sessions offered in a group setting over a 6-month period. These sessions provide training to make realistic and lasting behaviour changes around diet and exercise, helping individuals increase their level of physical activity, change their diet, and control their weight. After the core sessions, there are six less intensive follow-up meetings furnished monthly over the next six months to help participants maintain healthy behaviours.
The services can be availed virtually or in person from an approved Medicare Diabetes Prevention Program supplier. These suppliers may be traditional healthcare providers or organizations like community centres or faith-based organizations.
Medicare Part B also covers medical nutrition therapy services and weight-loss counselling for individuals with diabetes, kidney disease, or those who have had a kidney transplant in the last 36 months. This includes diabetes self-management training, which helps individuals monitor their blood sugar, follow healthy eating tips, and manage prescriptions.
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Medicare covers therapeutic shoes for those with diabetes-related foot conditions
Medicare Part B covers diabetes counselling and medical nutrition therapy services for people with diabetes and kidney disease. This includes diabetes self-management training, which consists of one hour of individual training and up to nine hours of group training. The training helps those diagnosed with diabetes to monitor their blood sugar, make healthier food choices, be more physically active, manage prescriptions, and reduce risks.
Medicare Part B also covers weight-loss counselling by a primary care provider to help individuals lose weight through diet and exercise. To qualify, you must have a body mass index (BMI) of 25 or higher, or 23 or higher for those of Asian descent, and meet certain blood sugar test requirements.
In addition to the above, Medicare Part B covers therapeutic shoes and inserts for people with diabetes and severe diabetes-related foot disease. This includes extra-depth shoes, custom-moulded shoes, and shoe inserts, which are designed to prevent lower-limb ulcers and amputations in people with diabetes. To qualify for this benefit, a podiatrist or other qualified doctor must prescribe the shoes or inserts, and the individual must be under a comprehensive diabetes care plan.
If you qualify for therapeutic shoes or inserts, you are limited to one of the following footwear categories within one calendar year:
- One pair of extra-depth shoes and three pairs of inserts
- One pair of custom-moulded shoes (including inserts) and two additional pairs of inserts
Medicare will pay for 80% of the Medicare-approved amount either directly to the patient or by reimbursement after the Part B deductible is met. The patient is responsible for a minimum of 20% of the total payment amount. It is important to note that Medicare will only cover therapeutic shoes if the doctors and suppliers are enrolled in Medicare, so be sure to ask your suppliers if they participate in Medicare before obtaining therapeutic shoes.
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Medicare covers weight-loss counselling
Medicare Part B (Medical Insurance) covers weight-loss counselling and medical nutrition therapy services if you have a body mass index (BMI) of 25 or more (BMI of 23 or more if you're Asian).
The Medicare Diabetes Prevention Program is a health behaviour change program to help prevent type 2 diabetes. The program begins with 16 weekly core sessions offered in a group setting over six months. In these sessions, you'll get training to make realistic, lasting behaviour changes around diet and exercise. To qualify, you must never have been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD).
Medicare Part B also covers weight-loss counselling by a primary care provider to help you lose weight through diet and exercise. The program includes an initial obesity screening, dietary assessment, and behavioural therapy. To qualify, you must have a BMI of 30 or higher. It is considered a free preventive benefit.
Original Medicare (Part A and Part B) covers weight loss programs, therapy, screenings, and surgery if your doctor or healthcare provider decides that treatment is medically necessary. Medicare Advantage (Part C) plans also cover weight loss programs when they are medically necessary.
Medicare will cover bariatric surgery if you meet specific eligibility criteria. However, you'll owe the standard Medicare plan costs for the procedure.
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Medicare covers diabetes self-management training
Medicare Part B (Medical Insurance) covers outpatient diabetes self-management training (DSMT) to help you manage your disease. This includes both initial and follow-up training, which is a "once-in-a-lifetime" benefit.
Medicare may cover up to 10 hours of initial training, consisting of one hour of individual training and nine hours of group training. You may also qualify for up to two hours of follow-up training each calendar year after the year you received your initial training.
Diabetes self-management training may include tips for eating healthily and being active, monitoring blood glucose (blood sugar), taking prescriptions, and managing prescriptions.
To qualify for this training, you must meet certain conditions. Firstly, within the 12 months before attending your first core session, you should have either a body mass index (BMI) of 25 or more (or 23 or more if you are Asian) and have never been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD). Additionally, you must not have participated in the Medicare Diabetes Prevention Program before.
The Medicare Diabetes Prevention Program is a health behaviour change program to help prevent type 2 diabetes. The program offers 16 weekly core sessions in a group setting over six months. During these sessions, you will receive training to make realistic and lasting behaviour changes regarding diet and exercise.
It is important to note that the treating provider must establish medical necessity for initial DSMT services via a written or e-referral. The treating provider, who must also be an active Medicare provider or in official opt-out status, can be a physician or qualified non-physician practitioner, such as a nurse practitioner or physician assistant.
Until September 30, 2025, you can access diabetes self-management training at any location in the US through telehealth. After this date, you must be in an office or medical facility located in a rural area to receive this training through telehealth.
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Frequently asked questions
Yes, Medicare Part B covers nutrition counseling for people with diabetes.
The Medicare Diabetes Prevention Program is a health behavior change program to help prevent type 2 diabetes. The program includes 16 weekly core sessions offered in a group setting over a 6-month period.
The program includes training to make realistic, lasting behavior changes around diet and exercise.
To qualify, you must have a body mass index (BMI) of 25 or higher, 23 or higher for someone of Asian descent, and meet certain blood sugar test requirements.
Medical Nutrition Therapy Services include an initial obesity screening, dietary assessment, and behavioral therapy.
