Does Medicare Pay For A Dietitian?
Medicare Part B may provide coverage for a dietitian or nutritionist if deemed medically necessary by your doctor.
Additionally, Medicare extends coverage to include diabetic counseling, weight-loss counseling, obesity screenings, and more.
Adopting a healthy diet significantly contributes to overall well-being, and Medicare beneficiaries dealing with specific health conditions have access to coverage options related to dietitians and nutritional therapy.
Medicare Part B and all Medicare Advantage (Medicare Part C) plans cover Medical Nutrition Therapy (MNT) services for individuals who:
- Have diabetes
- Are dealing with kidney disease
- Have undergone a kidney transplant within the last 36 months
To qualify for Medicare coverage for counseling with a registered dietitian or other nutritional counseling, your doctor must determine it to be medically necessary.
Beyond dietitian services, Medicare may also cover various nutritional treatments, including diabetic counseling, obesity screenings, and weight-loss counseling.
Gain a deeper understanding of how Medicare’s nutritional coverage operates.
When Does Medicare Pay For A Dietitian?
Medicare provides coverage for nutritional counseling, offering the following services with a nutritionist or dietitian:
- Initial Assessment:
- Evaluate your diet and lifestyle to develop a personalized plan.
- Individual and/or Group Sessions:
- Engage in nutritional therapy sessions tailored to your needs.
- Lifestyle Management Assistance:
- Receive guidance on managing lifestyle factors impacting your health.
- Follow-Up Visits:
- Benefit from ongoing support through follow-up visits.
Medicare also includes nutritional therapy as part of comprehensive dialysis care for beneficiaries undergoing dialysis in a facility.
In rural areas, nutritional therapy may be covered through telehealth.
Does Medicare Pay For A Dietitian?
Medicare covers three hours of nutritional therapy in the first year for beneficiaries with renal disease or diabetes, followed by two hours annually.
If additional therapy is deemed medically necessary, doctors can appeal to Medicare for further coverage.
While Original Medicare (Part A and Part B) offers these benefits, many Medicare Advantage (Part C) plans may extend coverage for dietitian services and nutrition counseling.
These plans, mandated to cover Original Medicare services, often include extra benefits such as prescription drugs, dental, vision, hearing, and more, potentially encompassing nutritionist services.
Understanding Medicare Coverage for Nutritionist Services
Medicare Part B Coverage
Nutritional therapy is covered by Medicare Part B, typically subject to a $203 annual deductible (in 2021) and a 20% coinsurance for covered care.
However, thanks to a provision in the Affordable Care Act, the deductible and coinsurance do not apply to nutritional therapy performed by a Registered Dietitian, resulting in no out-of-pocket costs.
If the service is provided by a nurse practitioner or another professional, a copayment or coinsurance may apply.
Medicare Advantage Plans
Additional Nutritional Benefits
Some Medicare Advantage plans go beyond, offering additional nutritional benefits such as home meal deliveries and healthy food options for plan members.
Coverage for Diabetic Counseling
Both Medicare Part B and Medicare Advantage plans cover various benefits related to diet and nutrition, including:
Coverage for diabetes self-management training (DMST), encompassing guidance on healthier eating, physical activity, blood sugar monitoring, medication management, and risk reduction.
Initial DMST sessions, up to 10 hours, include 1 hour of individual training and 9 hours of group sessions.
Obesity Screenings and Weight-Loss Therapy
Coverage for obesity behavioral therapy, involving a dietary assessment and counseling for weight loss through diet and exercise.
Initial coverage includes an obesity screening, with additional weight-loss counseling if your body mass index (BMI) is 30 or higher.
Coverage for bariatric surgery, such as gastric bypass and laparoscopic banding surgery (“lap band surgery”), if specific medical conditions related to morbid obesity are met.
Before seeking services with a dietitian, nutritional therapy, or bariatric surgery, consult your doctor to ensure Medicare coverage and determine potential costs.
If you have a Medicare Advantage plan, direct inquiries to your plan carrier for more information.
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