What Diabetes Education Services Does Medicare Provide?
If you have Medicare coverage and have been diagnosed with diabetes, you may have access to programs that will teach you how to manage your disease. Education services can help you understand your condition, monitor your blood sugar levels, and teach you how to incorporate exercise and a diabetes-friendly diet into your daily routine. Diabetes education through Medicare can help you live an active, healthy life.
Medicare Benefits Solutions
Apr 29, 2022
Whether you have been living with diabetes, were recently diagnosed, or just discovered you are pre-diabetic, it’s never too early or late to learn how to live with diabetes. Diabetic resources may include several providers, including your doctor, a nutritionist, and/or diabetes care and education specialist. Below are a few ideas to consider as you pursue a diabetes education.
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Learning to Live with Diabetes
Awareness is key to living with diabetes. Learn what triggers your blood sugar level to elevate or plummet. The American Diabetes Association describes common causes of hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar).
Hyperglycemia can result from:
- Too much food
- Insufficient insulin or medication
- Medication side effects
- Conditions that initiate the release of hormones, such as illness, stress and menstruation
Hypoglycemia can result from:
- Not enough food
- More insulin or medication than needed
- Medication side effects
- Higher than usual physical activity
Food and Nutrition
Whether or not you have diabetes, healthy eating is critical to your overall state of well-being. If you have diabetes, understand how specific foods impact your blood glucose levels. Track your carbohydrate intake. Invest in a food scale, measuring cups and measuring spoons, and keep these tools easily accessible in your kitchen. To reinforce your commitment to self-management, create a food diary.
Study functional foods that benefit people with diabetes. Research published in PubMed Central (PMC) that focused on functional foods to manage Type 2 diabetes, reported the protective qualities of whole grains, fruits, vegetables, legumes and nuts.
Healthy eating works hand-in-hand with exercise. When you engage in physical activity, your muscles burn sugar, facilitating insulin efficiency. You don’t have to run a marathon – housework and gardening works too. The Mayo Clinic advises the general population to work up to an average of 30 minutes of moderate aerobic exercise about five days per week. Work with your doctor to come up with a customized exercise plan.
Blood Sugar Monitoring
Discuss with your diabetes healthcare team the best way to monitor your blood sugar. Medicare may help cover meters and related supplies, including sensors for people who use continuous glucose monitors.
Does Medicare Cover Diabetes Education?
Medicare benefits include self-management training for people who currently have diabetes. A written order from your healthcare provider is a prerequisite for this outpatient training, which offers diabetes management tips and coping mechanisms.
Topics generally include:
- Eating healthy food
- Staying active
- Monitoring blood glucose levels
- Taking medication for diabetes
- Reducing your risk
The benefit is covered under Medicare Part B, and the patient responsibility includes the Part B deductible ($233 in 2022) and the coinsurance payment (20% of the Medicare-approved amount).
If you have diabetes or kidney disease, you may be eligible for medical nutrition therapy (MNT) services from a registered dietitian or nutrition professional. These services do not require that you meet your deductible or pay coinsurance, so if approved, you pay nothing for MNT.
Types of Diabetes Testing
If you experience increased thirst, urination and hunger (primary symptoms of diabetes), your doctor may check to see if you have impaired glucose tolerance (IGT), commonly known as prediabetes. IGT is a risk factor in the development of diabetes.
The Centers for Disease Control and Prevention (CDC) explains the various blood sugar tests your doctor may use to confirm a diagnosis:
- A1C test: Below 5.7% is normal, and 6.5% and up indicates diabetes.
- Fasting blood sugar test: A reading of 99 mg/dL or lower is normal, and 126 mg/dL and up signals diabetes.
- Oral glucose tolerance test: The normal range varies with the lapse in time after drinking a liquid containing glucose. After two hours, a blood sugar level equal to or less than 140 mg/dL is deemed normal, and 200 mg/dL or more suggests diabetes.
Does Medicare Cover Pre-Diabetes Education?
One of the preventive services Medicare covers under Part B is the Medicare Diabetes Prevention Program, designed to support your efforts to change behaviors that may prevent Type 2 diabetes. You must meet the following eligibility criteria:
- Enrollment in Medicare Part B
- Diabetes test results that reflect prediabetes, taken within 12 months of attending the first weekly core session
- Body mass index (BMI) no less than 25. If you are Asian, the cutoff is 23.
- No diagnosis of diabetes (Type 1 or Type 2) or end-stage renal disease (ESRD)
- No previous participation in the Medicare Diabetes Prevent Program (one-time benefit)
The program comprises group diabetes classes (core sessions), which you attend over a six-month period, followed by follow-up and maintenance meetings.
This diabetes education is structured to help you:
- Develop a realistic, long-lasting diet and exercise behavior
- Incorporate more activity into your lifestyle
- Learn strategies for weight management
- Stay motivated with the support of a formally trained coach
- Use a support group of people striving for goals and facing challenges comparable to your own
If you meet the qualifications and there is a Medicare Diabetes Prevention Program provider in your area, you incur no cost for these services.
Taking steps to get the support you need is empowering. To search for online and live diabetes education classes, contact local healthcare facilities and medical centers. Some of these programs are certified by the American Diabetes Association.
The following organizations can help direct you to diabetes resources available in your area: