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Medicare Diabetes Services and Prevention Program Costs

Adapted from Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs, Centers for Medicare & Medicaid Services. The selected guidance concerns Medicare coverage and payment, not a recommendation for medical treatment. Numbered page references below refer to the linked source publication.

Coverage can depend on medical necessity, the setting, provider participation, and your plan’s rules. Use the cited publication for the full conditions and check the plan year when comparing costs or enrollment choices.

Diabetes services & prevention programs

This section gives you information about services and prevention programs Medicare Part B (Medical Insurance) covers, including trainings to help you prevent, find, and treat diabetes. This section also gives you information about vaccines that Part B and Medicare drug coverage (Part D) cover.

ACCESS (Advancing Chronic Care with Effective, Scalable Solutions)

Starting July 5, 2026, Medicare is offering a new model to help people improve their health and prevent and manage chronic diseases (like diabetes). This is a voluntary model for people in Original Medicare. It connects your doctor with participating providers to help manage your chronic conditions. It may also help improve access to new technology-supported care options (like wearable blood pressure monitors and insulin detectors, and other convenient tools you can use at home) and might make your health care more affordable. Visit Medicare.gov/ACCESS to learn more.

Diabetes screenings

Part B covers blood glucose (sugar) laboratory test screenings if your doctor or other health care provider determines you’re at risk for developing diabetes. You may be at risk for diabetes if you have:

  • High blood pressure
  • History of abnormal cholesterol and triglyceride levels
  • Obesity (defined as a body mass index (BMI) of 30 or higher)
  • Impaired glucose (sugar) tolerance
  • History of high blood sugar

Part B also covers these screenings if you have 2 or more of these risk factors:

  • You’re overweight (defined as having a BMI between 25 and 29.9)
  • You have a family history of diabetes (parents or siblings)
  • You have a history of gestational diabetes (having diabetes during pregnancy) or gave birth to a baby weighing more than 9 pounds
  • You’re 65 or older

If you qualify to get diabetes screenings, you can get up to 2 screenings every year (within 12 months of your most recent screening). After your initial diabetes screening test, your doctor will determine if you need a second test. Medicare covers these diabetes screenings:

  • Fasting glucose (sugar) blood tests
  • Hemoglobin A1C tests
  • Other Medicare-approved glucose (sugar) blood tests as appropriate

If you think you may be at risk for diabetes, talk with your doctor to find out if you should get these tests.

Medicare Diabetes Prevention Program

Part B covers the Medicare Diabetes Prevention Program, a health behavior change program to help you prevent type 2 diabetes. The program begins with 16 weekly group sessions led by coaches in a group setting over a six-month period. In these sessions, you’ll get:

  • Training to make realistic, lasting behavior changes around diet and exercise
  • Tips on how to get more exercise
  • Strategies to control your weight
  • A specially trained coach to help keep you motivated
  • Support from people with similar goals and challenges

Once you complete the core sessions, you’ll get 6 monthly follow-up sessions to help you maintain healthy habits.

To qualify, you must be at risk for developing type 2 diabetes and have:

  • Part B (or a Medicare Advantage Plan)
  • Test results (within 12 months of your first session) that show you have prediabetes:
  • Hemoglobin A1C test result between 5.7% and 6.4%
  • Fasting plasma glucose of 110–125 mg/dL
  • 2-hour plasma glucose of 140–199 mg/dL (oral glucose tolerant test)
  • A body mass index (BMI) of 25 or more (BMI of 23 or more if you’re Asian)
  • No history of type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD)

How can I participate? Through December 31, 2029, you can choose to participate in-person or virtually, or through a combination of both. If you attend virtually, you can choose either live or self-paced sessions. You can get these services from an approved Medicare Diabetes Prevention Program supplier. These suppliers may be traditional health care providers or organizations like community centers or faith-based organizations.

Visit Medicare.gov/coverage/medicare-diabetes-prevention-program to find a program near you or online.

Diabetes self-management training

If you’ve been diagnosed with diabetes, Part B covers diabetes self-management training to help you learn how to manage your diabetes. Your doctor or other qualified health care provider must give you a written order for you to get this training.

How much training is covered? Medicare will cover up to 10 hours of initial training—1 hour of individual training and 9 hours of group training. You must complete the initial training within 12 months from the time you start it. You may also get 2 hours of follow-up training each year, after the year you get the initial training. The follow-up training can be one-on-one training or group sessions.

Important: Your provider may prescribe up to 10 hours of individual training, rather than group sessions. You may get individual training if you have low-vision, a hearing impairment, a language or other communication difficulty, cognitive limitations, or group sessions aren’t available within 2 months of the date of the order.

Where can I get this training? You must get this training from an approved individual or program as part of a plan of care your provider prepares. Your provider will usually give you information about where to get this training.

Diabetes self-management training is available in many Federally Qualified Health Centers (FQHCs). FQHCs give health care services to medically underserved people and groups who don’t have adequate access to health care. You don’t have to pay a Part B deductible. Visit findahealthcenter.hrsa.gov to find a health center near you.

What will I learn in this training? The first diabetes self-management training session is an individual (one-on-one) meeting to help the instructors better understand your needs. Classroom training will cover topics, like:

  • General information about diabetes, including:
  • Benefits of blood sugar control
  • Risks of poor blood sugar control
  • Blood sugar testing and how to improve your diabetes control
  • How diet, exercise, and medication affect blood sugar
  • How to manage and improve blood sugar control
  • Behavior changes, goal setting, and problem solving, including:
  • How to prevent, recognize, and treat complications from your diabetes
  • Nutrition and how to manage your diet
  • Why exercising is important to your health
  • Taking your medications properly
  • Foot, skin, and dental care
  • How to adjust emotionally to having diabetes
  • Family involvement and support
  • Using the health care system and resources in your community

Medical nutrition therapy services

In addition to diabetes self-management training, Part B covers medical nutrition therapy services if you have diabetes or kidney disease, and meet certain criteria. A doctor must refer you for these services. A registered dietitian (or certain other nutrition professionals) can give you these services:

  • An initial nutrition and lifestyle assessment
  • Nutrition counseling (what foods to eat and how to follow an individualized diabetic meal plan)
  • Tips on how to manage lifestyle factors that affect your diabetes
  • Follow-up visits to check on your progress

Medical nutrition therapy is available in many Federally Qualified Health Centers (FQHCs). Visit findahealthcenter.hrsa.gov to find a health center near you.

Foot care

If you have diabetes-related lower leg damage that can increase the risk of limb loss, Part B will cover one foot exam every 6 months by a podiatrist (foot doctor) or other foot care specialist, as long as you haven’t seen a foot care professional for another reason between visits. Medicare may cover more frequent visits if you’ve had a non-traumatic amputation of all or part of your foot and it isn’t caused by an injury, or your feet have changed in the way they look, which may signal that you have serious foot disease.

Hemoglobin A1C tests

A hemoglobin A1C test is a lab test that measures how well your blood glucose (sugar) has been controlled over the past 3 months. If you have diabetes, Part B covers this test if your doctor or other health care provider orders it.

Glaucoma screenings

Glaucoma screenings painlessly check your vision and optic nerve health to look for signs of the eye disease glaucoma. Part B will cover this screening once every 12 months if you’re at increased risk of developing glaucoma because you have at least one of these conditions:

  • Diabetes
  • A family history of glaucoma
  • Are African-American and 50 or older
  • Are Hispanic and 65 or older

An eye doctor who’s legally allowed to give this service in your state must give you the screening or supervise it.

Vaccines

If you have diabetes, you have a higher risk of complications from certain diseases. It’s important to stay up to date with recommended vaccinations to reduce your risk for infection. Talk with your doctor or other health care provider to find out about which vaccines are right for you.

Part B covers preventive vaccines for:

  • Flu
  • COVID-19
  • Hepatitis B
  • Pneumococcal

Part D covers all adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that aren’t covered under Part B, including Measles, Mumps and Rubella (MMR), Respiratory Syncytial Virus (RSV), Zoster (shingles), Tdap, and more.

“Welcome to Medicare” preventive visit

During the first 12 months that you have Part B, you can get a “Welcome to Medicare” preventive visit. During the visit, you and your doctor or other health care provider will talk about things like your medical and social history related to your health, education and counseling about preventive services (like screenings and vaccines), and referrals for other care you may need. The “Welcome to Medicare” preventive visit isn’t a physical exam.

Yearly “Wellness” visit

If you’ve had Part B for longer than 12 months, you can get a yearly “Wellness” visit. This visit can help you develop or update your personalized plan based on your current health and risk factors. The yearly “Wellness” visit isn’t a physical exam.

Medicare covers this visit once every 12 months. During this visit, your health care provider will:

  • Review your medical and family history.
  • Review your current prescriptions.
  • Take your height, weight, blood pressure, and other routine measurements.
  • Give you a written plan (like a checklist) letting you know what screenings, vaccines, and other preventive services you need.
  • Evaluate your potential risk factors for substance use disorder and refer you for treatment, if needed.
  • Perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease.

Supplies & services that Medicare doesn’t cover

Original Medicare and Medicare drug coverage (Part D) don’t cover:

  • Eyeglasses and exams for glasses, except after cataract surgery
  • Orthopedic shoes (shoes for people whose feet are impaired, but intact)
  • Cosmetic surgery
  • Routine physical exams

Source and further reading

Medicare Coverage of Diabetes Supplies, Services, & Prevention Programs — Centers for Medicare & Medicaid Services. Public domain U.S. government educational material, accessed October 28, 2026. Fynoptic has selected sections, removed print navigation, and reformatted the text for this guide. The agency does not endorse Fynoptic.

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