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Diabetes Self-Management, Supplies, and Other Medical Services—Introduction
Nearly 24 million people in the U.S. have diabetes, according to 2007 prevalence data from the CDC. Diabetes disproportionately affects older adults, and approximately 12 million or 23% of people ages 60 and older reported having this disease in 2007 (CDC).
Diabetes can cause serious health complications, including heart disease, stroke, blindness, and leg and foot amputations. It is the leading cause of blindness and end stage renal disease. People with diabetes are more susceptible to other illnesses, and once they acquire them, they often have worse prognoses. For example, people with diabetes are more likely to die of pneumonia and influenza than people who don't have diabetes.
Medicare covers services to help people with diabetes manage their condition so they can prevent or reduce the severity of diabetes-related complications. This website provides information and resources regarding Medicare benefits for diabetes self-management training, supplies, and other medical services that are important for beneficiaries to take advantage of to assist them in managing their diabetes.
Diabetes Self-Management Training
Medicare approves certain diabetes self-management training services to help beneficiaries successfully manage their disease. A beneficiary can receive diabetes self-management training services if he or she is at risk for complications from diabetes, has been recently diagnosed with diabetes, or has diabetes and is now eligible for Medicare. Beneficiaries pay 20% of the Medicare-approved amount after the yearly Part B deductible for diabetes self-management training services. The physician managing the beneficiary's diabetes must certify that diabetes self-management training services are needed under a comprehensive plan of care.
Therapeutic shoes
Medicare covers therapeutic shoes and inserts for beneficiaries who have Medicare Part B, have diabetes, and are being treated under a comprehensive plan of care. This benefit includes either 1 pair of custom-molded (including inserts provided with such shoes) and two additional pairs of inserts, or one pair of depth shoes and three pairs of inserts (not including the non-customized removable inserts provided with such shoes). Medicare beneficiaries pay 20% of the Medicare-approved amount after meeting the yearly Medical Part B deductible.
Diabetic supplies
Medicare covers blood glucose self-testing equipment and supplies, including monitors, insulin pumps, lancet device and lancets, and test strips and glucose control solutions. Beneficiaries pay 20% of the Medicare-approved amount after meeting the yearly Part B deductible. Injectable insulin is covered under the Medicare Part D Program. You must be enrolled in Part D to receive this benefit.
Other medical services
Medicare covers medical services which are important for people with diabetes to have routinely. These include foot care, hemoglobin A1c tests, and dilated eye exams for diabetic retinopathy. Other Medicare preventive benefits, including glaucoma screening and immunizations, are also important for people with diabetes. Medicare also covers the costs associated with pancreatic islet cell transplant clinical trials. CMS has several disease management demonstrations underway aimed at helping people with diabetes and other diseases manage their diseases.
A handful of links to information and resources related to diabetes self-management are also provided below.
Page Last Modified: 12/10/2008 10:28:22 AM
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