Medicare and Diabetes

Medicare and Diabetes

We have all heard of diabetes but have you ever heard of prediabetes?

Prediabetes means you have blood glucose (sugar) levels that are higher than normal, but are not high enough to be classified as diabetes. Detecting diabetes early can improve your quality of life by treating the condition before it results in more severe health problems.

If you have been diagnosed with prediabetes, Medicare will cover two diabetes screening tests each calendar year under Part B’s preventive care benefits. If you are at risk of diabetes because of other conditions, such as being over-weight, having high cholesterol or high blood pressure, Medicare will cover one screening every 12 months. This screening test includes a fasting plasma glucose test. Medicare will pay one hundred percent of the approved amount, under Part B, even before you have met your deductible.

If you are diagnosed with diabetes, Medicare will also cover a number of different services and supplies to help you learn how to manage your condition. Medicare will pay for up to ten hours of diabetes self-management training and education in your first year and an additional two hours every year thereafter.

Medicare will also pay for a routine glaucoma screening for people who are diagnosed with diabetes. People with diabetes are at high risk for developing glaucoma. Medicare will even help pay for some of the costs of medical nutritional therapy (with a doctor’s referral) to teach you how to eat right. They will pay for the cost of some of the supplies you need to control your diabetes, such as glucose monitors, control solutions, lancets and test strips, even if you don’t use insulin.

If you use an insulin pump, the insulin and the pump may be covered as durable medical equipment. You will need a prescription. Be sure to check with your durable medial equipment supplier before purchasing this outright. If you do not use a pump and you inject yourself with insulin, Part D, the Medicare Prescription Drug Plan, will cover the insulin and the supplies necessary to inject it: syringes, needles, alcohol swabs, etc. Be sure to check your Part D formulary to see if your plan covers these items.

If you have peripheral neuropathy because of your diabetes, Medicare will cover foot-care once every six months. Therapeutic shoes may even be covered by covered by Medicare, depending on the severity of your diabetes. Medicare will pay for these shoes once a year, with the proper documentation from your foot doctor.

Medicare has come a long way since it was first introduced in 1967. At that time, Medicare only paid for acute care services and every year Congress adds more and more items to the list of covered services.

Irene Card & Betsy Chandler are both licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.

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