ENTITLEMENT / MEDICARE-DIABETES-PREVENTION-PROGRAM

Centers for Medicare & Medicaid Services and approved suppliers

Medicare Diabetes Prevention Program

Medicare Part B covers a structured health-behavior program that helps eligible people with prediabetes prevent or delay type 2 diabetes.

Medicare Part B enrollee meeting Medicare Diabetes Prevention Program risk criteria

Entitlement facts

Benefit type
Government benefit. A government-funded or administered benefit, service, coverage program, assistance program, or public access route. Taxonomy definition →
What it unlocks
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.
Who qualifies
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.
How to activate
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 access. The core benefit has no required payment, purchase, deposit, paid membership, or pre-existing paid-product relationship under the captured terms.
Cost and 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.
Geography
US, Approved in-person and online Medicare supplier availability
Personalization
Published eligibility is not described as individually targeted.

EVIDENCE / 1 SOURCE

Eligibility is conditional, not guaranteed.

Check the provider's final terms immediately before applying, depositing funds, spending, or changing a paid relationship.