Diabetes: A National Plan for Action. Medicare Modernization Act of 2003 Improvements for Individuals with Diabetes


The new law enhances diabetes coverage for beneficiaries by adding several improvements.

  • Welcome to Medicare Physical
    Beginning in 2005, the new law provides new coverage of a one-time preventive physical exam within 6 months of a beneficiary’s enrollment under Part B. The initial preventive physical will consist of a comprehensive examination that will allow the physician to diagnose problems early when treatment is more effective. In addition, the physician and office staff will provide education, counseling and referral to other preventive services covered by Medicare.
  • Cardiovascular Screening Tests
    The new law provides Medicare coverage of cardiovascular screening blood tests, including tests for total cholesterol, high-density lipoprotein, and triglycerides.
  • Diabetes Screening Tests
    Beginning in 2005, the new law will supply new coverage of diabetes screening tests for persons at risk for diabetes, including a fasting plasma glucose test and such other tests as the Secretary may determine appropriate. Eligible risk factors include hypertension, dyslipidemia, obesity, prior dentification of impaired fasting glucose or glucose tolerance, or at least two of the following: overweight, family history of diabetes, history of gestational diabetes or delivery of a baby over 9 pounds.
  • Medicare Part D Drug Benefit
    The new Medicare Part D drug benefit will cover insulin and associated diabetic supplies (including syringes) beginning in 2006.
  • Medication Therapy Management
    Beginning in 2006, the new comprehensive prescription drug benefit will include drug therapy management for beneficiaries with multiple chronic diseases, including diabetes, who take multiple drugs and spend more than a specified amount annually on drugs covered under the prescription drug benefit. The drug management programs will help ensure the best therapeutic outcomes and reduce the risk of adverse medication events.

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