Medicare covers Medical Nutritional Therapy only if you have diabetes or kidney disease, or if you had a kidney transplant within the last three years, Part B may pay for nutritional therapy. The therapy services must help you manage your condition more effectively by choosing the right foods. If you’re on dialysis, coverage includes medical nutrition therapy services.
Medical Nutritional Therapy Guidelines for Medicare Coverage
Medicare covers Medical Nutritional Therapy because it improves health outcomes. For Medicare to cover it must be related to diabetes or kidney disease. Or, for those that have had a kidney transplant in the last 36 months.
There were about 15 million beneficiaries with diabetes or chronic kidney disease, but only about 100,000 of them received nutritional counseling services. Medicare will only cover Medical Nutritional Therapy if your doctor prescribes it; pay for three hours of Medical Nutritional Therapy in the first year you need services, and two hours in every year after that.
Medical Nutrition Therapy is a preventive health service, and therefore Medicare covers 100%. You won’t be responsible for any copay or deductible as long as you use a doctor that accepts Medicare assignment.
Does Medicare Cover Nutrition Counseling?
A doctor, a registered dietitian, or another nutrition expert that accepts Medicare may provide Medical Nutritional Therapy. Nutrition therapy can include a variety of services. It usually begins with an assessment of your eating habits, lifestyle, weight, and blood sugar levels. After that, the dietitian may develop an eating plan for you.
Many patients suffer from a wide range of medical conditions each year. If you have diabetes, Medicare may pay for one-on-one counseling as part of medical, nutritional therapy. You get assistance with managing lifestyle issues that affect your diabetes. You may have follow-up visits to monitor your progress.
Does Medicare Cover Medical Nutritional Therapy for Obesity?
Medicare covers obesity counseling for people who have a body mass index of 30 or more, regardless of whether they have diabetes or another weight-related health condition. For coverage, the counseling must take place in a primary care setting, such as a doctor’s office. You may receive advice from your doctor, a nurse practitioner, a clinical nurse specialist, or a physician assistant.
Medicare pays 100% of the cost of one session of “intensive behavioral therapy for obesity” per week for the first month, and a meeting every other week for the five months after that.
For people who lose at least 6.6 pounds in that first six months, Medicare will pay for one counseling session per month for another six months. If you haven’t lost at least 6.6 pounds by the end of the sixth month, you can still get extra weight loss counseling. However, you will have to wait six months before coverage.
Does Medicare Advantage Cover Nutrition Therapy?
All Medicare Advantage plans cover nutrition therapy for people who are eligible under Medicare’s rules. Plans can’t charge a deductible, copay, or coinsurance for these services when you use an in-network doctor.
Do Medicare Supplements Cover Nutritional Therapy?
Medicare covers medical, nutritional counseling; however, it only pays 80% of the doctor visits and outpatient treatments for underlying conditions. That’s why it’s essential to have a supplement plan. A supplement covers the 20% as well as offering further benefits.