Medicare Covers Diabetes Self-Management Training Services
Part 3 of a 3-part series, Education Services for Medicare Beneficiaries with Kidney Disease, from the American Kidney Fund
Did you know that if you have diabetes you are at increased risk for kidney disease? That’s right. Diabetes is the leading cause of kidney failure, causing nearly 40 percent of all cases. Diabetes is also a leading cause of heart disease, stroke, blindness and non-traumatic amputation.
Medicare knows that good diabetes self-management can help prevent diabetes-related complications. That’s why it offers a benefit that may help you learn to manage diabetes.
The Diabetes Self-Management Training Benefit
Medicare Part B covers up to ten hours of diabetes self-management training (DSMT) during the first year you are eligible. Plus, you can get up to two hours of training each year after that. If you have special needs, your doctor may request additional hours of individual training. You are responsible for any copayment or coinsurance. The Part B deductible also applies.
Most DSMT sessions are conducted in a group setting. Up to one hour of training may be conducted one-on-one during the first year. In rural areas, sessions may be held by phone or video, but at least one hour of training must be in person. Your doctor or another practitioner who treats your diabetes must refer you for DSMT.
DSMT training must be provided by an accredited program. Your referring provider can help you find a program in your area. Programs may be community-based or pharmacy programs, hospital-based outpatient programs, physician-based programs or individual programs. Health care providers with special training in diabetes conduct the program.
During the training sessions you will learn skills to help you make daily decisions about your diabetes management. You will also learn about lifestyle and other behavior changes that may help you manage your blood glucose levels and overall health. You will learn about:
Staying physically active
How food and activity affect blood glucose levels
Monitoring your blood glucose levels
Taking your medications
Identifying and overcoming blood glucose management problems
Coping with diabetes in a healthy way
Reducing your risk of long-term diabetes complications
With Original Medicare, you pay 20 percent of the Medicare-approved amount for diabetes self-management training. The Part B deductible applies.
Am I Eligible?
You may be eligible for DSMT if you have recently been diagnosed with diabetes, are at risk for diabetes complications or have diabetes and are new to Medicare. Talk to your health care provider to see if this benefit may be right for you.
If you are eligible for the DSMT benefit, you may also be able to receive other education services, including Kidney Disease Education and Medical Nutrition Therapy. These other services can also benefit patients with chronic kidney disease or diabetes.
To learn more about these additional benefits, you may want to read the first two articles in this series: Medicare Offers Kidney Disease Education Services and Medicare Covers Medical Nutrition Therapy Services.
For more information about kidney disease, its risk factors and treatment options, visit KidneyFund.org. If you are a healthcare professional wanting to learn more about education services for Medicare beneficiaries with kidney disease, please visit http://www.kidneyfund.org/professionals/ to take our online accredited continuing education course.
The American Kidney Fund fights kidney disease through direct financial support to patients in need, health education and prevention efforts. It leads the nation in charitable assistance to dialysis patients. Last year, nearly 84,000 people—1 out of every 5 U.S. dialysis patients—received assistance from the American Kidney Fund for health insurance premiums and other treatment-related expenses. The American Kidney Fund reaches millions of people annually through its national campaign, Pair Up: Join the Fight to Prevent Kidney Disease; free kidney health screenings; health education materials and courses; online outreach; and a toll-free health information HelpLine (866-300-2900). For more information, visit http://www.kidneyfund.org/.
For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. - 8 p.m. local time, seven days a week.
Medicare.gov: Visit the official U.S. government site for Medicare.
Y0066_130418_100116 CMS Accepted