Does Medicare cover diabetes screening?

What diabetes screening tests does Medicare cover?

Medicare Part B covers diabetes screenings, which are blood tests that check if you have or are at risk for diabetes. These screenings may be fasting or non-fasting glucose tests, A1C tests, or other Medicare-approved glucose tests. CMS's preventive services guide for providers says Medicare covers a hemoglobin A1C blood test when a patient gets a diabetes screening.

Who qualifies for Medicare diabetes screening?

Part B covers diabetes screenings if your doctor or other health care provider determines you're at risk for developing diabetes. You must have either:

• At least one of these risk factors: high blood pressure; a history of abnormal cholesterol and triglyceride levels; obesity; or a history of high blood sugar.
• Or 2 or more of these conditions: you're 65 or older; you're overweight; you have a family history of diabetes (parents or siblings); or you have a history of gestational diabetes (diabetes during pregnancy) or delivery of a baby weighing more than 9 pounds.
• CMS adds that people previously diagnosed with diabetes aren't eligible for this screening benefit.

How often does Medicare cover diabetes screening?

Medicare Part B covers up to 2 diabetes screenings each year, within 12 months of your most recent screening. CMS describes the schedule as 2 screenings within the 12-month period following the date of your most recent diabetes screening test.

What do I pay for a diabetes screening with Medicare?

You pay nothing for a diabetes screening if your health care provider accepts assignment, and CMS lists no copayment, coinsurance or deductible for it. Your doctor may recommend services that Medicare doesn't cover, or more often than Medicare covers them, which could mean extra costs for you, so ask what Medicare will cover. See what Medicare covers for blood work and lab tests.

What does Medicare cover if I'm at risk for type 2 diabetes or have diabetes?

If you're at risk for type 2 diabetes, Medicare Part B covers the Medicare Diabetes Prevention Program, a health behavior change program, and you pay nothing if you qualify. All of these conditions must apply: within 12 months before your first core session, you have a hemoglobin A1c test result between 5.7% and 6.4%, a fasting plasma glucose of 110-125 mg/dL, or a 2-hour plasma glucose of 140-199 mg/dL (oral glucose tolerance test); you have a body mass index (BMI) of 25 or more (23 or more if you're Asian); and you've never been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD). See Medicare and the Diabetes Prevention Program.

If you're diagnosed with diabetes, Part B covers outpatient diabetes self-management training when your doctor or other health care provider orders it, and you pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026). See Medicare and diabetic test strips.

Does Medicare Advantage cover diabetes screening?

Medicare Advantage Plans must cover all medically necessary services that Original Medicare covers, and plans may also offer extra benefits that Original Medicare doesn't cover. Plans may have different out-of-pocket costs and may require you to use providers in the plan's network for non-emergency care; for the Medicare Diabetes Prevention Program, Medicare.gov says you may have to go to an in-network provider, so contact your plan.