top of page

Medicare and Diabetes: Get the Coverage You Need


Blood testing
Image via Pixabay

If you’ve recently been diagnosed with diabetes, you should know that it is a disease you can control. Medical intervention as well as lifestyle and dietary changes can help you manage your blood sugar and improve your quality of life. Thankfully, diabetes is covered under Medicare Part B. In the following few paragraphs, we’ll touch on some important facts you should know about diabetes, Medicare, and treatment.


What is diabetes?

Diabetes is a chronic disease, and nearly a quarter of seniors have it. When you are diabetic, your body can’t use insulin effectively, or it does not produce the insulin you need for proper metabolic function. According to Suzanne Falck, MD, FACP, diabetes may be reversible if caught early enough. The majority of older adults diagnosed with diabetes are diagnosed with type II, where your body does not respond appropriately to insulin. Diabetes can cause or worsen other issues, such as gum disease, kidney disease, and cardiovascular disease. Diabetes can also cause nerve damage, erectile dysfunction, and inefficient digestion.


Diabetes treatment

Diabetes is treated with a combination of lifestyle changes and medication. One of the most frequently-used drugs to treat diabetes is called Metformin. According to GoodRX.com, all Medicare Advantage plans, as well as Medicare Part D drug coverage, provide benefits for Metformin. However, your doctor may prescribe supplemental medications that may not be covered under every Medicare Advantage or Medicare Part D plan.


Other drugs used to treat diabetes include Humalog and Lantus. When you also suffer from cardiovascular disease, your doctor may prescribe Jardiance. If you’re confused about coverage or are unfamiliar with the medical and insurance terms used to outline Medicare benefits, this online guide can help you begin to make sense of it all.


Medicare coverage

You will have to be diagnosed by a physician to receive Medicare benefits for diabetes. This is usually done by way of a fasting blood sugar test. You can test up to two times each year if you are considered high risk. Medicare pays for these tests in full if your doctor accepts the Medicare-approved payment amount. You may be responsible for 20 percent of the cost if your doctor accepts Medicare payments, but not the dollar amounts Medicare approves for specific services. So, for example, if Medicare approved $100, your doctor may charge $120. In this case, Medicare pays all but $20.


Medicare also offers benefits for at-home testing supplies. These might include a blood sugar monitor, test strips, and lancets. Your doctor will show you how to use these to self-monitor your diabetes.


Some people with prediabetes are also eligible for diabetes prevention care, which became available in April of 2018. People with a body mass index of greater than 25 who have been officially diagnosed as prediabetic can apply for this behavioral change program.


Am I at risk?

Type I diabetes is usually diagnosed in children or young adults. Type II, which is more common by far, may be triggered by many factors. These include being overweight and physically inactive, drinking an excess of sugar-sweetened colas and drinks, and a family history of diabetes. You can lower your risk by eating a balanced diet and avoiding processed sugars. OneTouch, a leading manufacturer of diabetic testing supplies, explains that type II diabetes is on the rise thanks to poor eating habits and less physical activity.


When you have a chronic condition, you want to do everything you can to keep it from interfering with your life. Fortunately, diabetes is manageable, and Medicare covers treatment once you’ve been diagnosed. But remember, lifestyle plays a huge role in both your risk and the reversal of the disease, so eat with the purpose of healing yourself, and make exercise a priority.


Article by Kevin Wells of seniordiabetic.com


16 views0 comments

Comments


bottom of page