Medicare Diabetes Prevention Program

The Medicare Diabetes Prevention Program helps members lose weight and adopt healthy habits to prevent Type 2 diabetes. The program is a one-time, lifetime benefit. For members who meet goals and weight-loss targets, it can be available for up to two years with no copay, coinsurance or deductible. Members need to have a blood screening test within the last 12 months to qualify.

What's included

  • Ongoing weight-loss maintenance sessions
  • A lifestyle health coach that helps members stay on target
  • Small, in-person support group sessions

Eligibility requirements 

  • Enrollment in Medicare Part B
  • Blood value: 
    • Fasting plasma glucose of 110-125 mg/dl or
    • A1C value between 5.7-6.4, or
    • Oral glucose tolerance test between 140-199 mg/dl
  • BMI greater than 25 (or if Asian, greater than 23) 
  • No diagnosis of end stage renal disease, Type 1 or Type 2 diabetes
  • A previous gestational diabetes diagnosis is acceptable 

While the program is available online, members need to give blood screening test results in person.

For more information, please read these documents:

Solera Health will help enroll qualified members into a MDPP in their area.

Please note: some flexibility with online classes, as well as temporary exceptions to the once per life-time requirement, are being allowed due to COVID-19.