Category: Managing Diabetes with Medicare

Get the most of your coverage so you can LIVE YOUR BEST LIFE!

When it comes to Medicare, there’s more than meets the eye. In this blog, we’ll explore 15 lesser-known services covered by Original Medicare, with a focus on Original Medicare Part B. Whether you’re a new beneficiary or a seasoned one, understanding these services can help you make the most of your coverage.

1. Welcome to Medicare Preventive Visit
   • Upon enrolling in Medicare, you’re entitled to a Welcome to Medicare visit. This comprehensive checkup with your Medicare-covered primary care physician establishes a baseline for your health and sets the stage for your upcoming health management plan.
2. Yearly Wellness Visits
   • In addition to the initial visit, Medicare covers an annual wellness visit with your primary care physician. This dedicated checkup ensures that your overall health is on track and allows for a review of your care plan.
3. Counseling to Quit Smoking
   • If you’re looking to quit smoking, Medicare has your back. Coverage includes up to eight face-to-face counseling sessions per year with a healthcare provider to support your journey to a tobacco-free life.
4. Flu Shots
   • Protect yourself from the flu with Medicare-covered flu shots, available at your doctor’s office or local pharmacy. Combined with good hygiene practices, flu shots are a powerful defense against influenza.
5. Nutrition Therapy Services
   • For those with qualifying conditions like diabetes or kidney disease, Medicare may cover nutrition therapy services. This includes assessments and individual and/or group nutritional therapy services.
6. Alcohol Misuse Screening & Counseling
   • Address alcohol misuse with Medicare’s coverage for annual screenings. If necessary, you can receive up to four face-to-face counseling sessions per year to help you manage your alcohol usage.

Note: You must get the counseling in a primary care setting. For example, like a doctor’s office.

7. COVID-19 Vaccination and Boosters
   • Stay protected from COVID-19 with Medicare-covered vaccinations and boosters. Accessible at your doctor’s office or local pharmacy, getting vaccinated not only safeguards you but also contributes to community health.
8. COVID-19 Tests (Including Antibody Tests)
   • Medicare covers all types of COVID-19 tests, ensuring you can get tested if you feel unwell. This includes at-home rapid tests and antibody tests to assess your potential immunity.
9. COVID-19 Monoclonal Antibody Treatments
   • If you test positive for COVID-19 with mild to moderate symptoms, Medicare covers monoclonal antibody treatments to help fight the virus and avoid hospitalization.
10. Obesity Screening & Counseling
    • Medicare Part B covers obesity screenings and counseling for individuals with a BMI of 30 or more. Work with your healthcare provider to focus on diet and exercise for a healthier lifestyle.

11. Gender-Specific Cancer Screenings
    • Medicare covers specific cancer screenings for both men and women, including prostate cancer screenings for men and mammograms/Pap smears for women.
12. Diabetes Self-Management Training
    • Newly diagnosed with diabetes? Medicare offers coverage for diabetes self-management training to help you cope with and manage your condition effectively. Medicare may cover up to 10 hours of this initial training – 1 hour of individual training and 9 hours of group training.
13. Special Footwear for Diabetes
    • For those with diabetes, Medicare may cover therapeutic shoes and inserts prescribed by an approved podiatrist to address foot neuropathy.
14. Colorectal Cancer Screenings
    • Medicare covers various diagnostic screenings for colorectal cancer, including stool DNA tests and colonoscopies. Regular screenings are essential for early detection.
15. Depression Screenings
    • Seniors can benefit from Medicare’s yearly depression screenings at no cost. If needed, referrals to mental health professionals or prescription options may be recommended.

Understanding your Medicare coverage is crucial for managing your health. These 15 covered services ensure that you receive the necessary screenings, tests, and support for a healthier and happier life. If you have questions about your coverage or want to explore additional options, feel free to reach out to our office at (631) 476-4015.

November is a crucial month in the health calendar as it is recognized as Diabetes Awareness Month. This is a time to bring attention to the disease and the millions of people affected by it. It’s also an excellent opportunity for us to shine a light on the importance of health, reminding everyone that your health matters!

1. Type 1 Diabetes: An autoimmune condition where the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes need lifelong insulin therapy.
2. Type 2 Diabetes: The most common form, often linked to lifestyle factors like poor diet and lack of exercise. It results in the body not using insulin properly or not producing enough, leading to elevated blood sugar levels.
3. Gestational Diabetes: A temporary form that occurs during pregnancy, usually resolved after childbirth, but it increases the risk of developing type 2 diabetes later in life.

Diabetes Management and Medicare: Know the Updates for 2024

One of the most significant challenges for those managing diabetes is the cost of the necessary supplies and medications. However, for Medicare recipients, there will be some important changes starting in 2024 that could make managing diabetes more affordable.

What’s Covered Under Medicare Part B:

• Injectable insulin used with a traditional insulin pump
• Insulin used with a disposable insulin pump
• Diabetes screenings and exams
• Diabetes self-management training (DSMT) – Medicare may cover up to 10 hours of this initial training – 1 hour of individual and 9 hours of group training. You may also qualify for up to 2 hours of follow-up training in each calendar year that falls after the year you got your initial training.
• Therapeutic shoes & inserts covered each calendar year:
• One pair of custom-molded shoes and inserts
• One pair of extra-depth shoes

Medicare will also cover:

– 2 additional pairs of inserts each calendar year for custom-molded shoes

– 3 pairs of inserts each calendar year for extra-depth shoes

In 2024, Medicare Part B will be extending the $35 monthly co-pay for insulin provided through durable medical equipment (DME). This is a significant improvement that will help many people manage their diabetes more effectively. Furthermore, blood sugar testing supplies will also be available with a $35 monthly co-pay, making it easier to monitor and manage diabetes-related complications.

Medicare Part D Coverage

For those using injectable insulin not associated with a traditional insulin pump or insulin used with a disposable pump, Medicare Part D has got you covered. Additionally, Part D covers certain medical supplies required for insulin injections, including syringes, gauze, and alcohol swabs. Insulin that is inhaled is also covered under Part D.

Starting January 2024, Medicare Part D will extend its coverage to include diabetes-related expenses. Under this plan, individuals can benefit from a $35 monthly co-pay for diabetes medications, and this cost won’t be subject to the plan’s deductible. This expansion is a positive step in making diabetes management more accessible and affordable for Medicare beneficiaries.

Medigap Coverage

If you have Part B and Medigap covering your Part B coinsurance, your plan should cover the $35/month (or less) cost for each covered insulin.

Reversal and Prevention- Keep Diabetes in Check!

Type 2 diabetes, which constitutes about 90-95% of all diabetes cases, is often associated with lifestyle factors. According to the International Diabetes Federation, over 50% of type 2 diabetes is preventable.  It’s essential to address preventive measures and potential reversals for individuals with type 2 diabetes or those at risk. For those with type 2 diabetes or at risk, lifestyle changes play a crucial role.

The 3 pillars to battle Diabetes are Weight loss, adopting a balanced diet, increasing physical activity.