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Medicare and Diabetes

Medicare was initially designed to covertaught by a certified diabetes educator (CDE)
acute care and it did not cover any routineor a registered nurse. Keep in mind, that
services such as an annual physical,the ten hours is for either diabetes
mammogram, prostate cancer screenings, etc.education, medical nutrition therapy or a
However, after 2002 Medicare Part B now payscombination of both. Anyone with Type 1 or
for routine diabetic services, supplies andType 2 diabetes can receive diabetes
education.education sessions if you have a referral
from your primary care physician and meet
- Screening - For people with Medicare atcertain  criteria.
risk for getting diabetes, Medicare covers
up to two screening blood sugar tests each to- Blood Glucose Monitoring Supplies- Medicare
check for diabetes. You are considered atwill cover the 80% of the costs of glucose
risk if you have any of the following: highmeters, strips and lancets after your Part B
blood pressure, dyslipidemia (history ofdeductible. If you are insulin dependent,
abnormal cholesterol and triglycerideMedicare will cover 100 test strips and 100
levels), obesity, or a history of high bloodlancets every month and one lancing device
sugar.every 6 months. If you are not insulin
dependent Medicare will cover this quantity
- Medical Nutrition Therapy - Medicalevery three months and one lancing device
nutrition therapy is meeting one on one withevery six months. If you need more than
a registered dietician or other certifiedthis, you will need a prescription from your
nutrition professionals to design the mealdoctor. For example, if you order a 3 Month
plan that helps you maintain blood glucosecomplete diabetic testing kit which includes
control. Your primary health care providera clinically accurate meter, strips and
must give you a referral indicating alancets from for about $60 then, your cost is
diagnosis of diabetes and a need for medical$12  (20%).
nutrition therapy. It also covers
gestational diabetes. Medicare will pay 80 %- Therapeutic Shoes-Therapeutic shoes are
of approved amount for up to ten hours ofcovered for Medicare beneficiaries with Type
counseling with a registered dietician or1 or Type 2 diabetes if they have a
other certified nutritional professional inperipheral  neuropathy.
an initial twelve month period. Bear in mind
that you can only receive a total of ten- Insulin Pumps-If you require an insulin
hours of medical nutrition therapy orpump to deliver small doses of insulin at
diabetes self-management education or aregular intervals throughout the day and
combination of both in the same twelve monthnight, Medicare will cover 80% of the
period. If follow-up sessions are needed,approved cost if you have Type 1 or Type 2
you will need a new referral from your doctordiabetes. Of course, you need a prescription
stating that your medical condition hasand you must have completed a diabetes
changed and adjustments to your meal plan areeducation  program.
necessary.
As always, check with your managed care
- Diabetes self-management education-representative as plans may vary.
Diabetes self-management education must be



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