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Medicare Part B: Coverage of preventative diabetes screenings

Medicare Part B covers doctors' services and outpatient care as well as preventative screenings. These preventative care measures play an important role in diagnosing and treating diabetes. All Medicare patients are eligible for an initial 'Welcome to Medicare' physical examination and a yearly wellness visit at no cost. These exams identify any potential health issues and, if certain risk factors are identified, individuals may be referred for additional screening.

Medicare Part B: what diabetes screenings are covered?

Diabetes screenings are covered for individuals with any of the following risk factors:

  1. History of high blood sugars
  2. High blood pressure
  3. History of abnormal triglyceride or cholesterol levels
  4. Obesity

Answering "yes" to two or more of the following questions also qualifies an individual for covered screenings:

  1. Are you age 65 or older?
  2. Are you overweight?
  3. Do you have a family history of diabetes?
  4. Were you ever diagnosed with gestational diabetes, or did you give birth to a baby weighing more than nine pounds?

Once qualified, a person can receive up to two diabetes screenings per year. No copay, coinsurance or deductible is required for the screenings at participating Medicare providers.

Other preventative screenings with Medicare Part B

For individuals who have been diagnosed with diabetes, other preventative services or screenings may be covered, such as foot exams every six months for individuals with diabetes-related foot complications or glaucoma screenings once a year. Patients must pay 20 percent of the Medicare-approved amount for the visit and the Medicare Part B deductible applies.

Additionally, with a doctor's prescription, individuals can sign up for diabetes self-management training programs, which include education on living with diabetes, eating healthy and managing the disease. Again, patients are responsible for 20 percent of the cost of the program and pay a deductible, if applicable. Early screening is an important step, as the sooner diabetes treatment begins, the lower the chances of diabetes-related complications in the long run. Check with a health care provider to find out what preventative exams are recommended.

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