Medicare Expands Coverage of Diabetes Prevention Program

Medicare coverage of diabetes treatment and diabetes prevention are expanding.

Medicare launched the Medicare Diabetes Prevention Program (MDPP) in 2018 as an expansion of the National Diabetes Prevention Program (DPP) model.

The MDPP is a partnership between Medicare and private organizations that provide education and lifestyle changes for people who are at risk for type 2 diabetes.

Man at the pool

What is the Medicare Diabetes Prevention Program (MDPP)?

The Medicare Diabetes Prevention Program starts with at least 16 core educational sessions over a six-month period.

These group classes are approved by the Centers for Disease Control and Prevention (CDC) and teach beneficiaries how to make healthy behavior changes to help prevent or delay the onset of diabetes.

The educational sessions offer benefits that include:

  • Group support from people with similar challenges and goals
  • Lifestyle coaching to help beneficiaries stay motivated
  • Weight control strategies
  • Exercise tips and strategies

After you complete the 16 core sessions, you can take part in additional monthly sessions to help you maintain the strategies you learned. The program goal is for beneficiaries to achieve at least five percent weight loss.

Why is the MDPP effective?

The MDPP presents an opportunity to invest in care for people who have prediabetes. This can help beneficiaries potentially save money on diabetes care and diabetes complications later in life.

Prediabetes is a condition where your blood sugar levels are higher than average, but you haven’t gotten to the level of being diagnosed with type 2 diabetes.

More than 25 percent of Americans age 65 and older are affected by diabetes, and type 2 diabetes is the most common form. Fortunately, type 2 diabetes is highly reversible with the right lifestyle changes.

You can talk to your doctor to find out if you have prediabetes and if you qualify for the Medicare Diabetes Prevention Program.

Does Medicare cover diabetes treatment and supplies?

Medicare coverage of the MDPP is in addition to a range of diabetes services already covered by Medicare. Medicare Part B provides benefits for diabetes treatment services and supplies, including:

  • Blood sugar testing monitors and test strips
  • Insulin
  • Lancet devices and lancets
  • Blood sugar control solutions
  • Therapeutic shoes or inserts
  • Diabetes self-management training
  • Yearly eye exam
  • Foot exam
  • Glaucoma tests
  • Nutrition therapy services

If you have a Medicare Advantage plan (Medicare Part C), your Medicare Advantage plan will also cover the MDPP and the diabetes supplies listed above. To learn more about joining an MDPP, you should contact your Medicare Advantage plan for more information.

Learning more about type 2 diabetes

CMS estimates that diabetes alone cost Medicare an extra $42 billion in 2016.  

The complications of type 2 diabetes can include diseases of the kidneys, nerves and eyes, complications in the heart, brain and blood vessels and neuropathy of the feet. All of these conditions are expensive to treat and contribute to higher Medicare spending.

Finding MDPP suppliers near you

CMS provides an interactive map you can use to find suppliers of MDPP services across the U.S.

To get help finding Medicare Advantage plans in your area that can help cover the MDPP, speak with a licensed insurance agent by calling TTY Users: 711.

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