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Did You Know? Your Insurer May Cover Diabetes Prevention

If your glycated hemoglobin (A1C) is between 5.7%-6.4%, you may be pre-diabetic. You can take steps to possibly prevent the progression to diabetes, and your health insurance or employer might cover diabetes prevention services! Read on to learn more.

What Is Prediabetes?

Those with prediabetes have a higher-than-normal blood sugar level that is not high enough for them to be classified as being diabetic. Stats from the CDC show that 33% of US adults (about 96 million people) are prediabetic and 80% of them don’t know it!

Why is it important to know if you are prediabetic? Because it means you are likely to develop type 2 diabetes, heart disease, or stroke.

Risk Factors

Those with prediabetes can be asymptomatic. If you have any of the following risk factors for prediabetes, you should speak to your doctor about getting tested:

  • Being overweight
  • Being 45 years or older
  • Having a parent, brother, or sister with type 2 diabetes
  • Being physically active less than 3 times a week
  • Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds
  • Being of the following race/ethnicity: African American, Hispanic/Latino American, American Indian, Pacific Islander, and some Asian American

Consider taking this self-test to understand your risk.

Testing

It’s simple: a straightforward blood sugar test.

Will My Insurance Cover Diabetes Prevention and Testing?

  • Medicare: Part B Preventive Services include coverage for screening tests for those with prediabetes. Specific coverage details are available here.
  • Medicaid: Visit your state’s department of health website to see if they cover diabetes prevention. The website will also provide information on partner organizations that offer lifestyle change and prevention programs. Here are examples of a couple of states that offer these programs:
  • Private Insurance: Contact your health insurance provider – they might be one of the many insurers who are providing coverage for screening tests and lifestyle change support programs for those with prediabetes.

Turns Out I am Prediabetic…What Next?

Check out this website: National Diabetes Prevention Program (NDPP). The Centers for Disease Control & Prevention (CDC) has developed NDPP to assist with kicking off—and sticking with—these lifestyle changes. How, may you ask?

  • By connecting you with a coach
  • Sharing resources on healthy eating and daily activity
  • Providing guidance on reducing stress and staying motivated
  • Peer support groups

What do the results show? A structured lifestyle change program like NDPP can reduce the risk of developing type 2 diabetes by 50% (even more if you are over 60 years)!

The best part is that CDC has recruited public and private organizations to partner in this effort: from employers to faith-based organizations to health insurance companies. You can view the list of private health plans, private employers, and public employers who participate in NDPP. A few state Medicaid programs and Medicare/Medicare Advantage plans also cover NDPP for enrollees.

Are you ready to enroll in NDPP? See if there’s a program offered near where you live.


Surabhi Dangi Garamella

Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.

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