Diabetes Prevention Program: An Examination, Eligibility Criteria, Choices, and Expenses
The Medicare Diabetes Prevention Program (MDPP) is a 12-month lifestyle change program designed to help individuals at risk of developing type 2 diabetes. This program, covered for eligible Medicare beneficiaries, follows the guidelines set by the Centers for Disease Control and Prevention (CDC) as part of its diabetes prevention efforts.
The MDPP consists of an initial core phase with at least 16 weekly sessions delivered over approximately 6 months, followed by a maintenance phase with monthly follow-up sessions for at least 6 additional months. The program covers key topics aimed at lifestyle modification, such as healthy eating habits, physical activity encouragement, weight loss strategies, and stress management techniques.
To be eligible for the MDPP, an individual must have a body mass index (BMI) of 25 or higher (23 for Asian individuals), have never participated in the program, and not have a diagnosis of type 1 or type 2 diabetes or end-stage renal disease (ESRD). Additionally, within 12 months of the first core session, an individual must have one of the following blood test results: a hemoglobin A1c test result between 5.7 and 6.4%, a fasting plasma glucose reading of 110-125 milligrams/deciliter (mg/dL), or a 2-hour plasma glucose reading of 140-199 mg/dL.
The MDPP can be delivered through various modes, including in-person, online, distance learning, or a combination of these to accommodate participants’ needs. The core sessions are conducted in a group setting, offering participants tips on exercise, nutrition, behavioural change, weight management, motivation, and support.
The MDPP's focus on sustainable lifestyle change through intensive education and long-term support is central to helping participants reduce their risk of developing type 2 diabetes effectively.
Both Original Medicare (Part A and Part B) and Medicare Advantage (Part C) provide coverage for diabetes-related services and supplies. Medicare Advantage (Part C) covers at least the services and supplies that Original Medicare (Part B) provides, and many Advantage plans also include prescription drug coverage. Deductibles, copays, and coinsurance apply to all the benefits provided by Original Medicare, Medicare Advantage, and the MDPP.
People who have overweight or obesity and are physically inactive have a higher risk of developing type 2 diabetes. The MDPP offers a valuable opportunity for these individuals to make lifestyle changes that can significantly reduce their risk of developing the condition.
[1] CDC. (2021). Diabetes Prevention Recognition Program. Retrieved from https://www.cdc.gov/diabetes/prevention/nationaldpp/index.html [2] CMS. (2021). Medicare Diabetes Prevention Program. Retrieved from https://www.cms.gov/medicare-and-medicaid-programs/care-management/diabetes-prevention-program/index.html [4] National DPP. (2021). National Diabetes Prevention Program. Retrieved from https://nationaldpp.org/
- The Medicare Diabetes Prevention Program (MDPP) is designed for individuals at risk of type 2 diabetes, following the guidelines set by the Centers for Disease Control and Prevention (CDC) and the National Diabetes Prevention Program (NDPP).
- The MDPP consists of an initial core phase with 16 weekly sessions, followed by a maintenance phase with monthly follow-ups, covering key topics like healthy eating habits, fitness and exercise, and weight management.
- To be eligible for the MDPP, individuals must have a body mass index (BMI) of 25 or higher (23 for Asian individuals), no diagnosis of type 1 or type 2 diabetes or end-stage renal disease (ESRD), and specific blood test results within 12 months of the first core session.
- The MDPP can be delivered via in-person, online, distance learning, or a combination of methods, with core sessions conducted in a group setting for peer support and encouragement.
- The MDPP's focus on sustainable lifestyle change through intensive education and long-term support is crucial in helping participants reduce their risk of developing type 2 diabetes, especially for those who are physically inactive and have overweight or obesity.
- Both Original Medicare (Part A and Part B) and Medicare Advantage (Part C) cover diabetes-related services and supplies, including the MDPP. Deductibles, copays, and coinsurance may apply to all benefits provided.
