How The Medicare Diabetes Prevention Program Works

Updated on December 16, 2020

 This twin year of 2020 has brought a lot of light on the importance of maintaining one’s good health. Everybody right from a lazy couch person to somebody who wakes up and performs yoga, it has been a wake-up call for everybody! But let us not forget that amidst this pandemic that the novel coronavirus has created, we must not remove focus from the already existing health conditions which are on the rise like never in the past one decade or so. And if you look around us and ask ourselves what is that one health condition that is most common amongst people all over the world, we would definitely agree that it is diabetes.

Diabetes is considered to be one of the most growing problems all over the world, especially in the United States of America. The statistics derived from the centers for disease control and prevention states that nearly 34,200,000 Americans have fallen prey to diabetes and nearly 88 million Americans already have prediabetes. And this number has continued to rise along with the medical complications that it brings along with it. It is said that every 1 in 10 Americans have diabetes. We all know that diabetes treatment is very expensive and not everybody can afford it. This is why certain government organizations like the CDC have come together with Medicare and come up with a program called MDPP (Medicare diabetes prevention program). This program’s main agenda is to help those at risk of diabetes and also diabetic people. There are certain qualifications for this program and if you fulfill those, then you are eligible for free treatment. You will get all the support, tools, and advice that will help you lead a happier and healthier lifestyle. 

What does Medicare screening include?

The Medicare company covers what is known as diabetes screening free of cost for all those people who are exposed to the risk of contracting diabetes. The testing procedure for this particular condition usually includes a measurement of fasting glucose, a normal blood test that will help know the sugar levels in the blood after a fasting period of 12 hours. 

You are suitable to undergo this diabetes screening test provided by Medicare every 12 months if you are having one of the below problems:

  • Dyslipidaemia, The problem of high cholesterol
  • Glucose intolerance, if you have a history of high blood sugar episodes
  • Obesity, if your body mass index is 30 and above
  • Hypertension is a cause of high blood pressure levels

You will be applicable for such type of screening twice a year if you are:

  • Aged 65 and above
  • You have a family history of diabetic people
  • If you are overweight
  • If you have just gestational diabetes

Medicare diabetes prevention program (MDPP)

The only goal of the purity of Medicare was to prevent any further diabetes among the people of the United States. Their primary goal was to help promote healthy eating and adequate physical activity amongst those who are more prone to contract diabetes. They wanted to inculcate a long time healthy lifestyle changes. For one to be eligible for the MDPP, they need to have a BMI of 25 and above and must not have any kind of the previous diagnosis of diabetes. You must also have an abnormal level of blood sugar which includes the following:

  • Test value of hemoglobin A1c test should be between 5.7–6.4%
  • Test value of plasma glucose on fasting must be 110–125MG/DL
  • Test value of plasma glucose of two hours should be between 140–199MG/DL

If you are eligible with the above-mentioned criteria then you will be permitted to participate in certain classes or programs which are CDC approved and these programs are tailored in a manner to decrease your chances of diabetes and increase your activity level, it will help you eat healthier and reduce your weight at the same time. 16 sessions are offered for the first six months. These are free opportunities offered just once in a lifetime. This MDPP program has shown a significant decrease in the emergency department of diabetes and also increased weight loss among its people by 5%.

What are the services provided in this program?

MDPP will provide you with the same services no matter which part of Medicare you will be using. This is a two-year program that is divided into 3 phases. Every single phase will have certain set goals for you to accomplish along with a team of support.

First phase: Core sessions

This phase is for six months. In this particular stage, 16 group sessions will be held. Each of these sessions will be for one hour, once a week. The sessions will be guided by an MDPP coach who will teach you about fitness, weight loss, and healthy eating. The coach will also track your progress in every session. 

Second phase: Core maintenance sessions

From your seventh month to your 12th, you will be in the second phase. You will be attending six sessions in the second phase. During this phase, you will be getting expert help to develop healthy habits and your weight will be tracked continuously. For you to move to the next phase, you will have to show that you are making progress in the second phase of the MDPP program. You will have to show a weight loss of at least 5%. If you fail to do so then Medicare wants to cover your expenses when you move to the next phase.

Third phase: Ongoing maintenance sessions

The third phase is the final one and it lasts for a whole year. This year is divided into four periods of three months and is called intervals. You will be required to attend two sessions during each of the periods and will have to continue to meet the weight loss requirements to be able to continue the program. Your coach will help and guide you as you adjust to a new lifestyle and diet habits. 

What are the other things that are covered under Medicare in this program?

As mentioned earlier the main goal of MDPP is to prevent diabetes. The other coverage under part we include:

  • Diabetic supplies — like glucose monitors, insulin pumps, and test strips.
  • Foot care and exams — everybody knows that the health of shit gets affected during diabetes. Therefore, every six months a foot examination will be done. Medicare will also take care of the expenses for special shoes.
  • Self-management of diabetes — this will teach how to monitor blood sugar, inject insulin, and much more on your own.
  • Diabetic screenings — the expenses of two screenings every single year are covered by this program.
  • Eye examinations – Medicare will give you money to undergo a glaucoma screening once a month since people who are diabetic are at an increased risk of it.

The Takeaway

  • Understand that if you have prediabetes then MDPP will guide you to prevent type-2 diabetes.
  • MDPP participation is free of cost if you qualify.
  • You need to at least indicate that you have prediabetes to qualify.
  • This program will help you bring healthy lifestyle changes.
  • The MDPP program lasts for two years.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.