What is the Medicare Diabetes Prevention Program?

The Medicare Diabetes Prevention Program is designed to help you learn how to modify your health and habits to prevent type 2 diabetes. The program includes sessions and follow-ups that can last for up to two years, and Medicare will completely cover the program if you meet certain health requirements.

Christian Simmons, writer and researcher for RetireGuide
  • Written by
    Christian Simmons

    Christian Simmons

    Financial Writer

    Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.

    Read More
  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

    Read More
  • Published: May 17, 2021
  • Updated: November 1, 2022
  • 3 min read time
  • This page features 6 Cited Research Articles
Fact Checked
Fact Checked

Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.

Cite Us
How to Cite RetireGuide.com's Article

APA Simmons, C. (2022, November 1). What is the Medicare Diabetes Prevention Program? RetireGuide.com. Retrieved June 2, 2023, from https://www.retireguide.com/medicare/services/preventive/diabetes-prevention-program/

MLA Simmons, Christian. "What is the Medicare Diabetes Prevention Program?" RetireGuide.com, 1 Nov 2022, https://www.retireguide.com/medicare/services/preventive/diabetes-prevention-program/.

Chicago Simmons, Christian. "What is the Medicare Diabetes Prevention Program?" RetireGuide.com. Last modified November 1, 2022. https://www.retireguide.com/medicare/services/preventive/diabetes-prevention-program/.

Why Trust RetireGuide.com
Why You Can Trust Us

Content created by RetireGuide and sponsored by our partners.

Key Principles

RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family.

RetireGuide LLC has partnerships with Senior Market Sales (SMS) and GoHealth.

Our partners are able to be reached through the phone numbers and/or forms provided on our website.

The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency.

Editorial Independence

While the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes.

We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information.

Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever.

What Is the 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.

What does the six-month program include?
  • Weight loss and weight control strategies
  • Exercise tips
  • A trained coach to help you

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.

Who Is Eligible for the Medicare Diabetes Prevention Program?

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.

You also must meet the criteria of one of three different blood tests:
  • A hemoglobin A1c test result between 5.7 and 6.4 percent
  • A fasting plasma glucose test result of 110 to 125 mg/dL
  • A 2-hour plasma glucose test result of 140 to 199 mg/dL

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.

How to Enroll

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.

Last Modified: November 1, 2022

6 Cited Research Articles

  1. Harvard Medical School. (2021, February 3). The Importance of Exercise When You Have Diabetes. Retrieved from https://www.health.harvard.edu/staying-healthy/the-importance-of-exercise-when-you-have-diabetes
  2. U.S. Centers for Disease Control and Prevention. (2020, June 11). Prediabetes — Your Chance to Prevent Type 2 Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/prediabetes.html
  3. U.S. Centers for Medicare & Medicaid Services. (2018, October). Medicare Diabetes Prevention Program Expanded Model. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MDPP-MLN34893002.pdf
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Diabetes Prevention Program. Retrieved from https://www.medicare.gov/coverage/medicare-diabetes-prevention-program
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Map of MDPP Suppliers Furnishing MDPP Services. Retrieved from https://innovation.cms.gov/innovation-models/medicare-diabetes-prevention-program/mdpp-map
  6. U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Diabetes Prevention Program (MDPP) Beneficiary Eligibility Fact Sheet. Retrieved from https://innovation.cms.gov/files/fact-sheet/mdpp-beneelig-fs.pdf