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While most of us could probably benefit from nutrition counseling, Medicare only covers the service for certain beneficiaries. Seniors with one of three approved health conditions may qualify for medical nutrition therapy (MNT) services through their Part B coverage. Even better, these services are covered at 100% because coinsurance and the Part B deductible do not apply.
If you have any questions about Medicare coverage, our experienced Medicare agents are always here to help. In this article we’ll cover the basics of what you need to know before you schedule an appointment with a nutritionist under your Medicare coverage.
What is Medical Nutrition Therapy?
According to cdc.gov, medical nutrition therapy is a key element of diabetes education and management. MNT is defined as a “nutrition-based treatment provided by a registered dietitian nutritionist.” It includes “a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes.”
In practical terms, MNT provides:
Comprehensive nutrition therapy
In-depth personalized nutrition assessment
Creates goals, a care plan, and interventions
Follow-up to reinforce behavioral and lifestyle changes relevant to each patient’s personal nutrition problems and medical condition or disease(s)
If you have diabetes, your doctor may also talk to you about Diabetes Self-Management Training (DSMT). CMS considers DSMT and MNT to be complimentary services but will not reimburse them if they are provided on the same day.
Does Medicare Cover a Nutritionist / Nutrition Counseling?
Seniors with certain health conditions may especially benefit from nutrition services including nutrition and lifestyle guidance with follow-up measures to ensure progress. Medicare provides medical nutrition therapy as part of a patient’s overall care for beneficiaries with certain health conditions.
If you have been diagnosed with kidney disease / receive dialysis at a dialysis facility, have diabetes, or you have had a kidney transplant in the past 36 months, you may qualify for free nutrition counseling through your Medicare Part B benefits. A referral from a doctor is required to receive MNT through Medicare.
How can seniors access dietician services through Medicare?
Seniors can access MNT through a registered dietician who accepts Medicare assignment, either one-on-one or in a group setting. In person or telehealth services may both be available.
In the first year after referral, Medicare will cover three hours of nutrition therapy, and two hours in the years that follow.
Does Medicare cover nutrition therapy for obesity or weight loss?
Obesity or the desire to lose weight alone is not a qualifying health condition for nutrition services. Medicare does cover obesity screenings and behavioral counseling for seniors who are considered medically obese (with a BMI of 30 or higher). If you are obese and also have diabetes or kidney disease then you should qualify for medical nutrition therapy.
Does Medicare cover nutrition therapy for prediabetes?
No, a Medicare beneficiary may not receive MNT services covered under Part B unless they have been diagnosed with diabetes, kidney disease, or have received a kidney transplant in the last 36 months.
Do Medicare Advantage plans cover nutrition services?
All Medicare Advantage plans must include all services provided in Medicare Part A and Medicare Part B so they do cover MNT under the same qualifying rules as Original Medicare. Seniors on Medicare Advantage may need to seek a referral to a registered dietician within their plan’s network.
Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.
At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.