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Commentary by David Sayen
| Thursday, Aug 13, 2015

Sayen,David_FlagDiabetes is a serious disease. It can lead to kidney problems, glaucoma and other eye disorders, foot ulcers, amputation of feet or legs, stroke, diabetic coma, and even death.

If your doctor thinks you’re at risk for diabetes, Medicare covers screening tests for it. And, if you develop the disease, Medicare covers a wide variety of medications, home testing equipment, supplies, and self-management training to help you cope with it.

Screening tests are used to detect diabetes early. Some of the conditions that may qualify you as being at risk for diabetes include:

* High blood pressure;

* Dyslipidermia (a history of abnormal cholesterol and triglycleride levels);

* Obesity (with certain conditions);

* Impaired glucose (blood sugar) tolerance;

* High fasting glucose (blood sugar).

Medicare will pay for two diabetes screening tests in a 12-month period. After the initial screening, your doctor will determine when to do the second test.

You and your doctor can discuss diabetes and any other health concerns you have during a “Welcome to Medicare” visit. Medicare covers this one-time review of your health, including counseling on any screenings, shots, or other care you may need. (You must have this visit within the first 12 months you’re enrolled in Medicare Part B.)

In addition, Medicare covers an annual wellness visit with your doctor, during which you can develop or update a personalized prevention plan, based on your current health and risk factors.

If you do develop diabetes, Medicare pays for self-management training to help you learn how to successfully manage the disease. Your doctor must prescribe this training for Medicare to cover it.

The training covers a variety of topics, including the risks of poor blood sugar control; nutrition and how to manage your diet; options to improve blood sugar control; exercise and why it’s important to your health; and how to take your medications properly.

Also, Medicare covers medical nutrition therapy services, to help you learn what foods to eat and how to follow an individualized diabetic meal plan.

Generally, Medicare Part B (medical insurance) covers services and supplies needed by people who have or are at risk for diabetes. Medicare Part D (the prescription drug program) helps pay for supplies for injecting or inhaling insulin.

Here are some of the items covered under Part B:

* Home blood sugar monitors and related supplies, such as test strips, lancet devices, and lancets;

* Foot exams and treatment (needed by people with diabetic peripheral neuropathy and loss of protective sensation);

* Glaucoma tests;

* External insulin pumps and insulin the devices use:

* Therapeutic shoes or inserts;

* Screening tests, “Welcome to Medicare” visits, and annual wellness checkups.

Items covered under Part D include:

* Drugs for maintaining blood sugar;

* Insulin that isn’t administered with a pump.

Medicare doesn’t cover everything, of course. Among the diabetes supplies and services not covered are:

* Eye exams for glasses (called refraction);

* Orthopedic shoes (for people whose feet are impaired but intact);

* Cosmetic surgery.

You can do many things to control your diabetes. Talk with your doctor about what, how much, and when you eat. Also talk with him or her about how much you should weigh, and the different ways you can reach your weight goal.

Take your medications as directed, and discuss any problems you encounter with your physician. Be active for a total of 30 minutes most days. Keep tabs on your blood sugar levels, blood pressure, and cholesterol.

If you smoke, quit. Medicare also covers counseling on how to stop smoking, if your doctor orders it.

For more details on Medicare’s coverage of diabetes, read the brochure titled “Medicare’s Coverage of Diabetes Supplies & Services,” at: https://www.medicare.gov/Pubs/pdf/11022.pdf.

 

David Sayen is Medicare’s regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can get answers to your Medicare questions 24/7 by calling 1-800-MEDICARE (1-800-633-4227).

Comment On This Story
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1 Comment

  1. marry says:

    I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2014. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn’t right and began to do a lot of research. On April 13th I found this book on http://www.wje592.com/i-am-finally-free-of-diabetes/. I read the book from end to end that night because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100, the next day was in the 90’s and now i have a fasting blood sugar between Mid 70’s and the 80’s. My doctor took me off the metformin after just one week of being on this lifestyle change. I have lost over 30 pounds in a month. I now work out twice a day and still have tons of energy. I have lost 6+ inches around my waist and I am off my high blood pressure medication too. I have about 20 more pounds to go till my body finds its ideal weight. The great news is, this is a lifestyle I can live with, it makes sense and it works. God Bless the writer. I wish the ADA would stop enabling consumers and tell them the truth. You can get off the drugs, you can help yourself, but you have to have a correct lifestyle and diet. No more processed foods.

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