What is the Free Medicare Diabetes Prevention Program?
Type 2 diabetes is a leading health concern in the United States. According to the Centers for Disease Control and Prevention (CDC) report, at least 37.3 million people have diabetes, accounting for 11% of the US population. The report also reveals that 96 million people aged 18 years or older have prediabetes—that’s 38% of the adult population.
The Medicare Diabetes Prevention Program (DPP) is free for those who are eligible. It was designed with the intention to manage the soaring numbers of diabetes cases in the US. It consists of health coaching sessions focused on developing lifestyle habits that can help to prevent or delay the progression of prediabetes to type 2 diabetes.
This comprehensive guide covers everything you need to know about the Medicare DPP.
Who qualifies for the Medicare DPP?
Medicare diabetes prevention program participants must meet eligibility criteria to qualify for the program. They should have Medicare Part B coverage (medical insurance) or the Medicare Advantage Plan. Besides these requirements, participants should also meet the following conditions;
- No history of participating in the program
- No End-Stage Renal Disease (ESRD) history
- No history of type 1 or type 2 diabetes
- A body mass index of 25 or more or 23 for Asians
- Lab test results confirming you have prediabetes. A prediabetes diagnosis can be demonstrated through hemoglobin A1c test results between 5.7-6.4%, fasting plasma glucose of 110-125 mg/dL, or 2-hour plasma glucose of 140-199 mg/dL.
What are Medicare DPP sessions like?
The Medicare DPP runs for two years but is divided into three phases.
1. Core session
The primary or core session takes place during the first six months of the program. It consists of 16 weekly one-hour group-based sessions in a classroom-like setting in or near your local healthcare facility. Dedicated Medicare DPP coaches lead the sessions. Program beneficiaries learn the following:
- Learning nutrition habits you can sustain long-term
- The importance of daily physical activity
- Behavior change tips for reaching or managing your weight goals
2. First follow-up session
Phase two starts at month seven and ends at month 12. While it should run for six sessions, some programs offer additional sessions for this phase. The coaches continue to track beneficiaries’ weights and offer helpful tips on weight management around details physical fitness and nutrition.
Graduating from phase two requires proof of progress. Participants aim to lose at least 5% of your bodyweight by month 12—according to the DPP’s research funded by the National Institutes of Health (NIH).
3. Second follow-up session
This last phase of the program lasts 12 months. It is split into four intervals, each three months long. Each period includes at least two group sessions. Participants are required to attend at least eight sessions within the entire 12-month phase. Participants are encouraged to maintain their weight loss in order to continue the program.
Participants don’t have to worry about missing an occasional session because the program allows providers to offer makeup sessions as needed.
Participants have three session makeup options. You can attend one-on-one sessions with the coach or join another group. Alternatively, you can organize virtual makeup sessions with the program coaches.
How to join the Medicare diabetes prevention program
If you have prediabetes and are interested in joining the Medicare DPP, get the ball rolling by talking to your doctor. Your doctor is responsible for verifying the different criteria that required for enrolling in the program.
Joining the program should be quick and simple after you meet the eligibility criteria. Below is a step-by-step guide to follow.
- Step 1: Click the link to visit the Medicare.gov/talk-to-someone page.
- Step 2: Scroll halfway through the page and select “Find programs near you” on the Learn about preventing diabetes tab.
- Step 3: A new page, the “Medicare Diabetes Prevention Programs” landing page, opens. Select your state in the drop-down menu and click ‘go’ to access a list of approved Medicare diabetes prevention program suppliers in your location.
The Medicare DPP is an excellent opportunity to help you delay or prevent the progression of prediabetes to type 2 diabetes. It’s free! You don’t want to miss out if you qualify. Be sure to contact Medicare for further assistance.
Learn more about Medicare enrollment.