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An Update from the National Diabetes Education Program and The Centers for Medicare and Medicaid Services: July 20, 2005
People with diabetes can tap into
several Medicare benefits to help control diabetes. This is the
second of three columns.
The information provided here refers to benefits under the original fee-for-service
Medicare plan. This Medicare Plan has two parts: Part A (Hospital Insurance)and
Part B (Medical Insurance). The Part B Medicare deductible is $110 in 2005, but
that amount may change in subsequent years based on a statutory formula. If you
are in a Medicare managed care plan, contact your plan to find out how these
diabetes benefits are covered.
People with diabetes can tap into several Medicare benefits to help control
diabetes and avoid serious health problems. These benefits will help with
day-to-day management of diabetes.
Medicare helps pay for diabetes self-testing equipment and supplies,
including blood glucose meters, test strips, and lancets (the devices to
stick your finger)prescribed by your health care provider. You may purchase
your supplies at your pharmacy, hospital, or clinic or you may order them
by mail. If you qualify, you pay 20 percent of the
Medicare-approved amount after you have met your Part B deductible.
Diabetes self-management training helps you learn how to manage your
diabetes successfully. Your doctor or other qualified health care provider must
prescribe this training for you for Medicare to cover it. You will learn how
to manage your blood glucose, how to make informed choices about nutrition
and exercise, and how to prevent and treat complications of diabetes.
You must get this training from a certified diabetes self-management
education program.
These programs are certified by the American Diabetes Association (ADA) or
the Indian Health Service (IHS). Your doctor or a qualified non-physician health
care provider will give you information about where to get diabetes
self-management training.
You also may check with the American Diabetes Association or the Indian Health
Service to find a Medicare-approved training program near you (see the list
of resources at the end of this article). If there isn't a certified training
program in your area, ask your doctor to refer you to a registered dietitian
to get the covered diabetes self-management training--or contact your local
Medicare contractor.
Medicare will cover a total of 10 hours of initial training within a
12-month period. You pay 20 percent of the Medicare-approved amount after
you have met the yearly Part B deductible.
Medical nutrition therapy services help you learn to eat healthy foods to
keep your diabetes in control. Your doctor must prescribe these services
for you. A registered dietitian or nutrition professional provides medical
nutrition therapy services. These services may include:
Ask your doctor to refer you to a nutrition professional or contact the
American Dietetic Association (see the resource list). You pay 20 percent of the
Medicare-approved amount after you have met the yearly Part B deductible.
Medicare pays for several other services for people with diabetes who have
Medicare Part B. You need a doctor's prescription for these services:
Medicare also covers foot care and exams if you have nerve damage in either
of your feet due to diabetes. One foot exam every six months by a podiatrist
or other foot care specialist is allowed. You do not need a doctor's
prescription for this service.
Medicare Information
1-800-MEDICARE (1-800-633-4227)
Information About Certified Diabetes Self-management Education Programs
American Diabetes Association
Indian Health Service
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