Medicare and Diabetes

Medicare was initially designed to cover acute careself-management education must be taught by a
and it did not cover any routine services such ascertified diabetes educator (CDE) or a registered
an annual physical, mammogram, prostate cancernurse. Keep in mind, that the ten hours is for
screenings, etc. However, after 2002 Medicareeither diabetes education, medical nutrition therapy
Part B now pays for routine diabetic services,or a combination of both. Anyone with Type 1 or
supplies and education.Type 2 diabetes can receive diabetes education
- Screening - For people with Medicare at risk forsessions if you have a referral from your primary
getting diabetes, Medicare covers up to twocare physician and meet certain criteria.
screening blood sugar tests each to check for- Blood Glucose Monitoring Supplies- Medicare will
diabetes. You are considered at risk if you havecover the 80% of the costs of glucose meters,
any of the following: high blood pressure,strips and lancets after your Part B deductible. If
dyslipidemia (history of abnormal cholesterol andyou are insulin dependent, Medicare will cover 100
triglyceride levels), obesity, or a history of hightest strips and 100 lancets every month and one
blood sugar.lancing device every 6 months. If you are not
- Medical Nutrition Therapy - Medical nutritioninsulin dependent Medicare will cover this quantity
therapy is meeting one on one with a registeredevery three months and one lancing device every
dietician or other certified nutrition professionals tosix months. If you need more than this, you will
design the meal plan that helps you maintain bloodneed a prescription from your doctor. For
glucose control. Your primary health care providerexample, if you order a 3 Month complete diabetic
must give you a referral indicating a diagnosis oftesting kit which includes a clinically accurate
diabetes and a need for medical nutrition therapy.meter, strips and lancets from for about $60
It also covers gestational diabetes. Medicare willthen, your cost is $12 (20%).
pay 80 % of approved amount for up to ten- Therapeutic Shoes-Therapeutic shoes are
hours of counseling with a registered dietician orcovered for Medicare beneficiaries with Type 1 or
other certified nutritional professional in an initialType 2 diabetes if they have a peripheral
twelve month period. Bear in mind that you canneuropathy.
only receive a total of ten hours of medical- Insulin Pumps-If you require an insulin pump to
nutrition therapy or diabetes self-managementdeliver small doses of insulin at regular intervals
education or a combination of both in the samethroughout the day and night, Medicare will cover
twelve month period. If follow-up sessions are80% of the approved cost if you have Type 1 or
needed, you will need a new referral from yourType 2 diabetes. Of course, you need a
doctor stating that your medical condition hasprescription and you must have completed a
changed and adjustments to your meal plan arediabetes education program.
necessary.As always, check with your managed care
- Diabetes self-management education- Diabetesrepresentative as plans may vary.