What is the Medicare Diabetes Prevention Program?

The Medicare Diabetes Prevention Program is a preventive series of courses in a supportive environment designed to help people with prediabetes make beneficial health and lifestyle changes to avoid becoming diabetic.

You are prediabetic if your blood sugar is already elevated but not enough to classify you as having type 2 diabetes. More than a third of American adults have prediabetes. The Medicare Diabetes Prevention Program can help move you in the right direction so that you don’t eventually develop type 2 diabetes.

The program starts with at least 16 one-hour group sessions that span a period of six months. In a classroom-style setting, you will get tips, training and information to help you live a healthier lifestyle that you can actually sustain.

The program covers possible changes to your diet as well as exercise strategies. Exercise is critical to preventing diabetes since physical activity can lower your blood glucose levels and increase your body’s insulin sensitivity. According to the U.S. Centers for Medicare & Medicaid Services, the Diabetes Prevention Program has reduced the incidence of diabetes in people ages 60 and older by 71 percent.

After the initial six-month course is complete, you can get six monthly follow-up sessions to help make sure you are sticking to your diet and exercise plans. If you are meeting your goals, you can get up to a year of additional sessions after the first year.

Medicare Part B will cover the Diabetes Prevention Program if you meet certain requirements. Since the courses are specifically designed to help people with prediabetes, you cannot have been previously diagnosed with type 1 or 2 diabetes or end-stage renal disease. Your body mass index (BMI) must also be at least 25, or 23 if you are of Asian descent. Medicare will only pay for you to do the Diabetes Prevention Program once in your lifetime, so this cannot be your second time enrolling in the program.

These tests must have been taken within the last year. Medicare will cover the entire program if you meet all these requirements, leaving you with no out-of-pocket costs.

The U.S. Centers for Medicare & Medicaid Services offers a map to search for the Diabetes Prevention Program supplier who is closest to you, along with their contact information.

You can switch your supplier even after you have begun your courses, but it’s important to remember that your one lifetime enrollment is in affect as soon as you begin, so Medicare will not pay for additional courses if you drop out and try to return later.

If you develop diabetes while you are enrolled in the program, you can continue your courses.