{"id":"medicare-diabetes-prevention-program","name":"Medicare Diabetes Prevention Program","provider":"Centers for Medicare & Medicaid Services and approved suppliers","entitlement_type":"government-benefit","entitlement_type_label":"Government benefit","entitlement_type_context":{"definition":"A government-funded or administered benefit, service, coverage program, assistance program, or public access route.","domain":"public-benefits","archetype":"direct-program","agent_instruction":"Identify the administering jurisdiction and disclose income, household, age, disability, immigration, residence, renewal, fee, and capacity rules that apply."},"summary":"Medicare Part B covers a structured health-behavior program that helps eligible people with prediabetes prevent or delay type 2 diabetes.","benefit":{"description":"Sixteen weekly core group sessions over six months, followed by six monthly maintenance sessions, with coaching on lasting diet, physical-activity, and weight changes. Approved delivery can be in person, live online, hybrid, or self-paced online under current rules.","estimated_value_usd":null},"discovery":{"focus":"public-service","has_estimated_dollar_value":false},"access":{"relationships":["Medicare Part B enrollee meeting Medicare Diabetes Prevention Program risk criteria"],"requirements":"The participant must have Medicare Part B, a qualifying blood-test result within the 12 months before the first core session, a body-mass index of at least 25 or at least 23 for an Asian participant, and no prior diagnosis of type 1 or type 2 diabetes or end-stage renal disease. Services must come from an approved supplier, and Medicare Advantage network rules may apply.","activation":"Review the qualifying test and body-mass-index criteria with a clinician, use Medicare's supplier search to find an approved in-person or online program, and confirm network participation with a Medicare Advantage plan before enrolling.","cost_basis":"no-cost","cost_basis_label":"No-cost access","cost_basis_context":{"classification":"free","definition":"The core benefit has no required payment, purchase, deposit, paid membership, or pre-existing paid-product relationship under the captured terms.","agent_instruction":"Still disclose optional add-ons, transportation, parking, replacement charges, taxes, capacity, and eligibility conditions found in fees or requirements.","variation_patterns":null,"does_not_mean":null},"fees":"An eligible participant pays nothing for the covered program. Unapproved suppliers, noncovered tests or services, and out-of-network Medicare Advantage care can cost money; coverage does not include unrelated gym, food, device, or weight-loss expenses.","personalized":false,"regions":["US","Approved in-person and online Medicare supplier availability"],"expires":null},"status":"verified","last_checked":"2026-08-04","claim_url":"https://www.medicare.gov/coverage/medicare-diabetes-prevention-program","source_url":"https://www.medicare.gov/coverage/medicare-diabetes-prevention-program","source":{"primary_url":"https://www.medicare.gov/coverage/medicare-diabetes-prevention-program","evidence":[{"source":"Centers for Medicare & Medicaid Services and approved suppliers","url":"https://www.medicare.gov/coverage/medicare-diabetes-prevention-program","kind":"provider","checked_at":"2026-08-04"}]},"parent":null,"coverage":{"level":"national","family":"health-and-counseling","jurisdiction":"United States","maturity":"direct"},"web_url":"/benefits/medicare-diabetes-prevention-program","taxonomy":{"version":"1.0","url":"/api/v1/taxonomy"}}