Diabetes and kidney patients can now get a valuable Medicare nutrition benefit as part of their Medicare coverage.
The estimated 15 million Medicare enrollees with diabetes or chronic kidney disease are eligible for the benefit. But Medicare for seniors aged 65 and older, only paid for 100,000 recipients to get this counseling in 2017, the latest year data is available. The data does not include the seniors enrolled in private Medicare Advantage plans.
The program pays for three hours of dietary counseling during the first year the benefit is used and two hours in subsequent years. A doctor can appeal for additional nutritional therapy if the physician believes it is medically necessary.
Diabetes Patients: Congress Approves Benefit 2002
Congress approved the benefit in 2002, after studies found such counseling leads to improved health and fewer complications for senior citizen patients. Under the Affordable Care Act (ACA), this counseling was made available without out-of-pocket costs to Medicare beneficiaries since 2011.
Nutritional counseling, especially for senior citizens, can improve health and save Medicare money by preventing costly complications from the diseases.
This is supported by statistics. Right now, 25 percent of seniors, aged 65 and older suffer from diabetes. And, 33 percent of seniors have kidney disease. Further, may cases of kidney disease are, in fact, a complication of diabetes.
In addition, fewer than 5 percent of Medicare beneficiaries use their benefit of 10 to 12 hours of diabetes self-management training. This training covers individual and group sessions — and gives tips for eating healthily, being active, monitoring blood sugar, taking drugs and reducing risks.
It’s puzzling as to why so few Medicare enrollees know this valuable benefit exists. There are certainly more than enough dietitians. Currently, there are 100,000 registered dietitians in the United States.
Getting The Word Out
Why do so few diabetes and kidney patients know that this nutrition counseling exists? Possible reasons could be that few doctors know about it — or they do, but don’t refer their patient to a dietitian. Referrals are mandatory.
Right now in the United States, cases of diabetes and obesity are at epidemic rates, according to the Centers For Disease Control. Treating these patients with surgeries, dialysis and amputations, is exorbitantly expensive . Therefore, using the nutritional counseling benefit provided by Medicare, will go a long way to reduce these costs and improve health.
This is particularly true in the case of senior citizens. Changing their behavior is difficult, especially when it comes to nutrition. The current three hours is insufficient and some dietitians believe it should be tripled, at least.
According to the Center for Medicaid Services, the agency is advising health providers about this nutrition benefit. They promote it to their members on their website and highlight it in their annual handbook sent to beneficiaries.
One problem, is that currently Medicare only covers two diseases for nutrition counseling, diabetes and kidney disease. If more chronic diseases were covered, such as cardiovascular, there would be greater publicity.