Medicare 2026

Just Diagnosed With Diabetes on Medicare? Two Benefits That Help You Learn to Manage It

A new diabetes diagnosis brings a lot at once: new terms, new routines, maybe new prescriptions, and a pile of questions about food, exercise, and blood sugar. If you have Medicare, two benefits are designed to help you build those skills with trained professionals — often with little or no cost to you. Many people never hear about them. This explainer walks through what they are, who qualifies, and how to ask for them.

Benefit 1: Diabetes Self-Management Training (DSMT)

Diabetes self-management training is a structured education program for people newly diagnosed with diabetes (and for people whose situation has changed). Part B covers it when a doctor or other provider orders it. The sessions teach the practical skills that make day-to-day life with diabetes workable:

• Healthy eating
• Being active
• Monitoring blood sugar
• Taking prescription drugs correctly
• Reducing long-term risks

Medicare allows up to 10 hours of initial training — typically 1 hour one-on-one and 9 hours in a group setting — plus up to 2 hours of follow-up training each calendar year after the year of your initial training. The group format isn't just a cost-saver; many people find it easier to learn alongside others facing the same questions.

What it costs: DSMT is not free. After you meet the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount. If you have a Medigap policy or other secondary coverage, that cost-sharing may be reduced; if you're in a Medicare Advantage plan, your plan's cost-sharing rules apply. Ask your plan what to expect.

How to get started: Ask your doctor for a referral to a Medicare-recognized DSMT program. If you don't know where to look, Medicare.gov has a care-finder tool, and 1-800-MEDICARE can help.

Benefit 2: Medical Nutrition Therapy (MNT)

Medical nutrition therapy is one-on-one work with a registered dietitian or other qualifying nutrition professional. It's covered for people with diabetes, kidney disease, or a kidney transplant in the last 36 months, when a doctor refers you.

Here's the part many people miss: if you qualify and your doctor refers you, you pay nothing for MNT — no deductible, no coinsurance.

Medicare covers:

• 3 hours in the first calendar year of service (these hours can't be carried into the next year, so use them)
• Up to 2 hours of follow-up each calendar year after that
• Additional hours if your doctor refers you because a change in your condition calls for a change in diet

DSMT and MNT are different services and can work together. DSMT gives you the broad education; MNT gives you a dietitian who can look at your actual meals, medications, and goals and build a plan that fits your life.

Telehealth makes both easier to use

You don't have to drive to an office. Medicare covers telehealth services from anywhere in the U.S., including your home, through December 31, 2027, and both diabetes self-management training and medical nutrition therapy are on Medicare's list of telehealth-eligible services. That makes it realistic to fit sessions around work, caregiving, or mobility limits.

A note on screening — for family and friends not yet diagnosed

If you have loved ones who haven't been diagnosed but may be at risk, Part B covers up to 2 diabetes screening blood tests a year for people with at least one risk factor (high blood pressure, abnormal cholesterol or triglycerides, obesity, or a history of high blood sugar), or with two or more conditions such as being 65 or older, being overweight, or having a family history of diabetes. These screenings cost nothing when the provider accepts assignment.

How your coverage choices fit in

Diabetes care often means more prescriptions, more supplies, and more visits. A few program-level facts worth knowing for 2027:

• The Part D out-of-pocket cap is $2,400 in 2027 (it is $2,100 in 2026). Once your out-of-pocket drug spending reaches that cap, you pay $0 for covered Part D drugs for the rest of the year.
• The maximum Part D deductible any plan can charge in 2027 is $700.
• The Part D base beneficiary premium for 2027 is $41.33. This is a national figure used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.
• The 2027 Part B standard premium and deductible have not been announced yet. CMS typically releases those figures in the fall.
• 2027 IRMAA income brackets (the income-related surcharges on Part B and Part D for higher earners) have not been announced yet either.
• Social Security announced a 3.6% cost-of-living adjustment for benefits payable beginning January 2027.

Annual Enrollment runs October 15 – December 7, 2026, with changes taking effect January 1, 2027. This is the main window to review your Part D drug plan or compare Medicare Advantage and Original Medicare + Medigap based on how your diabetes care is shaping up. Neither path is "better" — each has trade-offs around provider networks, out-of-pocket exposure, extra benefits, and the freedom to see any Medicare provider. The right fit depends on your doctors, your prescriptions, your budget, and how you like to get care.

If you have Medicaid or Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated D-SNP in any month.

Where to go next

Ask your doctor for referrals to DSMT and MNT — both, if you qualify. For official rules, provider lookup tools, and plan comparisons, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7.