Medicare Diabetes Prevention Program
Medicare Coverage Information
Overview
The Medicare Diabetes Prevention Program is a structured lifestyle intervention designed to help Medicare beneficiaries at high risk of developing type 2 diabetes. The program provides comprehensive coaching and support to help participants make lasting lifestyle changes that can prevent or delay diabetes onset.
- Offers intensive lifestyle intervention for individuals with prediabetes
- Includes group coaching sessions focused on diet and physical activity
- Provides ongoing support to help participants achieve weight loss and health goals
- Designed for Medicare beneficiaries at high risk of developing type 2 diabetes
- Focuses on sustainable lifestyle modifications
- Medicare beneficiaries with prediabetes
- Body Mass Index (BMI) of 25 or higher (22 or higher for Asian Americans)
- Previous diagnosis of gestational diabetes
- Fasting plasma glucose between 110-125 mg/dL
- 2-hour plasma glucose between 140-199 mg/dL during oral glucose tolerance test
- No cost-sharing for eligible participants
- Covered 100% by Medicare when provided by a certified program
- Typically requires no copayment or deductible
- Must meet specific eligibility criteria for prediabetes
- Limited to beneficiaries with specific body mass index (BMI) and blood sugar levels
- Requires consistent participation in program sessions
- Coverage may vary by specific Medicare plan
- Consult with primary care physician about diabetes risk
- Request a prediabetes screening
- Ask your doctor for a referral to a Medicare Diabetes Prevention Program
- Contact Medicare at 1-800-MEDICARE for specific program details
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare diabetes preventiondiabetes prevention programMedicare lifestyle coachingdiabetes risk reductionMedicare preventive services
Related Coverage Topics
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