Does Medicare Cover Nutrition Counseling?
Medicare is a federal health insurance program for adults aged 65 years or older and certain younger people with disabilities.
Depending on your eligibility, it covers certain doctors’ services, preventative services, hospital and skilled nursing facility stays, and medications, among other services.
However, you may wonder whether Medicare covers nutrition counseling from a registered dietitian.
This article discusses whether Medicare covers nutrition counseling, and if so, what nutrition-related conditions Medicare covers.
Medicare covers nutrition counseling
Registered dietitians — also known as registered dietitian nutritionists — provide nutrition counseling to treat and prevent diseases.
Nutrition counseling is also known as medical nutrition therapy (MNT).
While nutrition counseling can improve or treat most conditions, Medicare Part B (medical insurance) only covers nutrition counseling for diabetes and chronic kidney disease (1).
It also covers nutrition counseling if you have had a kidney transplant within the previous 36 months.
Medicare Advantage plans also cover nutrition counseling for these conditions.
Medicare Advantage is offered by a private company as an alternative to the original Medicare but it must follow the same coverage rules.
To receive nutrition counseling from a dietitian for these conditions, the dietitian must be enrolled as a Medicare provider and you must obtain a referral from your doctor.
Medicare covers up to three hours of nutrition counseling in the first year and up to two hours of counseling in the following years.
However, if your doctor believes you will benefit from more nutrition counseling, they can provide a second referral and Medicare will cover the additional hours.
Medicare covers nutrition counseling if you have diabetes, chronic kidney disease, or have had a kidney transplant within the previous three years.
Benefits of nutrition counseling for diabetes and kidney disease
If you have diabetes, chronic kidney disease, or both, nutrition counseling can help prevent, delay, and improve your health outcomes.
Diabetes is a condition in which your body doesn’t produce enough insulin or effectively use it.
Insulin is a hormone produced by the pancreas that lowers blood sugar or glucose by transporting it to your cells for energy or storage.
Without enough insulin or a poor response to its effects, your blood sugar can become dangerously high or low.
Over time, these fluctuations in blood sugar can damage blood vessels and nerves throughout your body.
Fortunately, through nutrition counseling, a dietitian can help you improve your blood sugar control through your diet and reduce the long-term complications of uncontrolled diabetes.
To this point, an analysis of 11 studies containing more than 1,200 patients with diabetes found a significant reduction in fasting blood sugar and hemoglobin A1c — a measure of your average blood sugar levels over the past three months — following nutrition counseling from a dietitian (2).
The patients in the analysis also experienced significant improvements in body weight, cholesterol, and blood pressure.
Chronic kidney disease
Chronic kidney disease is the progressive and gradual decline in kidney function.
With kidney disease, your kidneys can’t effectively perform important functions, which can cause anemia, bone disease, fluid retention, and increase your risk of heart disease.
While progressive, you can slow the progression of kidney disease, improve your symptoms, and reduce the risk of health complications by making dietary changes with the help of a dietitian.
Indeed, an analysis of eight studies demonstrated a significant improvement in blood pressure, which could prevent or delay the need for dialysis (3).
Another study also showed that people with kidney disease who received nutrition counseling were less likely to start dialysis and had improved markers of kidney health (4).
Nutrition counseling provided by a dietitian can help you improve your blood sugars with diabetes and reduce the progression of kidney disease, potentially delaying or preventing the need for dialysis.
Does Medicaid cover nutrition counseling?
Medicaid provides health coverage to some people with limited income and resources.
Unlike Medicare, Medicaid is both a federal and state program.
The federal government has specific rules that all states must follow but each state runs its own program.
Therefore, whether Medicaid covers nutrition counseling largely depends on the state in which you live.
For example, South Dakota Medicaid covers nutrition counseling from a dietitian for conditions like:
- celiac disease
- failure to thrive in childhood or adulthood
- low appetite
- feeding difficulties
- insulin resistance or high blood sugar
- end-stage renal disease
To receive nutrition counseling as an eligible Medicaid beneficiary, the dietitian must be enrolled as a Medicaid provider with your state.
Similar to Medicare, states also generally require that you obtain a referral from your doctor.
The number of hours or sessions of nutrition counseling that Medicaid covers varies by state.
While Medicaid is a federal program, each state runs its own program. Therefore, the state in which you live determines whether Medicaid covers nutrition counseling and to what extent.
The bottom line
Medicare is a federal health insurance program for people aged 65 years and older and younger people with certain disabilities or conditions.
Medicare covers nutrition counseling provided by a registered dietitian who is enrolled as a Medicare provider if you have diabetes, chronic kidney disease, or have had a kidney transplant within the previous three years.
You can receive up to three hours of nutrition counseling in the first year and up to two hours of counseling in the following years.
Medicaid — while a federal program — is administered at the state level, so each state has its own rules for nutrition counseling coverage.