Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) recently sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, urging CMS to step up Medicare coverage of diabetes.
Collins and Shaheen have long been proponents of diabetes research and better care, taking action to increase funding.
Those on Medicare who are insulin dependent rely on devices such as patch pumps. Therapies that are covered by private insurance are not always covered by Medicare, so when beneficiaries age into Medicare they are not covered for certain essential therapies they need to live.
Diabetes is a growing problem in the U.S. of which health care costs are projected to triple by 2035. Senator Collins started the Senate Diabetes Caucus in 1997 to raise funds for diabetes research, and those funds have gone up to more than $1 billion in 2017.
“Effective management of diabetes is crucial to holding down health care costs and helping seniors manage their diabetes successfully to allow them to continue to live healthy and productive lives,” wrote Shaheen and Collins. “We urge your careful review of Medicare coverage policies for patch pumps and other life-saving therapies for diabetes, in accordance with applicable laws and regulations, and to review the procedures at CMS that have resulted in these disparities in coverage.”
Medicare Coverage of Diabetes
So what does Medicare cover for diabetes?
Medicare covers two screening tests a year to check if you have diabetes, and medications, testing equipment, and supplies for diabetics. Also covered are training for managing the disease and nutrition therapy services. Medicare Part B covers the diabetes services received in a doctor setting plus some durable medical equipment, and Part D covers drugs that you get a pharmacy. Check Medicare’s website to see the exact rules for coverage of diabetes services and supplies.
Diabetes Prevention Program
In 2018, Medicare will expand the Medicare Diabetes Prevention Program (MDDP), a program to help those with diabetes or prediabetes lose weight and alleviate symptoms. The MDDP aims to use a “structured behavioral change intervention” program to prevent type 2 from becoming rampant among aging Americans.
As more and more Americans struggle with diabetes, prevention and management of day-to-day living are critical to living a healthy life with this disease. Stay tuned for updates on diabetes care and decisions by CMS.