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Article #349: Medicare and Diabetes

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Medicare was initially designed to cover Diabetes self-management education must
acute care and it did not cover any be taught by a certified diabetes
routine services such as an annual educator (CDE) or a registered nurse.
physical, mammogram, prostate cancer Keep in mind, that the ten hours is for
screenings, etc. However, after 2002 either diabetes education, medical
Medicare Part B now pays for routine nutrition therapy or a combination of
diabetic services, supplies and both. Anyone with Type 1 or Type 2
education. diabetes can receive diabetes education
- Screening - For people with Medicare at sessions if you have a referral from your
risk for getting diabetes, Medicare primary care physician and meet certain
covers up to two screening blood sugar criteria.
tests each to check for diabetes. You are - Blood Glucose Monitoring Supplies-
considered at risk if you have any of the Medicare will cover the 80% of the costs
following: high blood pressure, of glucose meters, strips and lancets
dyslipidemia (history of abnormal after your Part B deductible. If you are
cholesterol and triglyceride levels), insulin dependent, Medicare will cover
obesity, or a history of high blood 100 test strips and 100 lancets every
sugar. month and one lancing device every 6
- Medical Nutrition Therapy - Medical months. If you are not insulin dependent
nutrition therapy is meeting one on one Medicare will cover this quantity every
with a registered dietician or other three months and one lancing device every
certified nutrition professionals to six months. If you need more than this,
design the meal plan that helps you you will need a prescription from your
maintain blood glucose control. Your doctor. For example, if you order a 3
primary health care provider must give Month complete diabetic testing kit which
you a referral indicating a diagnosis of includes a clinically accurate meter,
diabetes and a need for medical nutrition strips and lancets from for about $60
therapy. It also covers gestational then, your cost is $12 (20%).
diabetes. Medicare will pay 80 % of - Therapeutic Shoes-Therapeutic shoes are
approved amount for up to ten hours of covered for Medicare beneficiaries with
counseling with a registered dietician or Type 1 or Type 2 diabetes if they have a
other certified nutritional professional peripheral neuropathy.
in an initial twelve month period. Bear - Insulin Pumps-If you require an insulin
in mind that you can only receive a total pump to deliver small doses of insulin at
of ten hours of medical nutrition therapy regular intervals throughout the day and
or diabetes self-management education or night, Medicare will cover 80% of the
a combination of both in the same twelve approved cost if you have Type 1 or Type
month period. If follow-up sessions are 2 diabetes. Of course, you need a
needed, you will need a new referral from prescription and you must have completed
your doctor stating that your medical a diabetes education program.
condition has changed and adjustments to As always, check with your managed care
your meal plan are necessary. representative as plans may vary.
- Diabetes self-management education-






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