Original Medicare (Parts A & B): Diabetes Self-Management Training (DSMT)

What it is

Diabetes self-management training (DSMT) teaches the person with diabetes to cope with and manage their diabetes. The program may include tips for eating healthy and being active, monitoring blood glucose (blood sugar), taking prescription drugs, and reducing risks. Some patients may also be eligible for medical nutrition therapy (MNT) training (a separate benefit).

Up to 10 hours of this initial training - 1 hour of individual training and 9 hours of group training are covered. Up to 2 hours of follow-up training in each calendar year after the year of initial training may also be available.

For those who already have diabetes, whether insulin or non-insulin users, it typically takes a number of self-management techniques and a variety of supplies to adequately manage it and prevent complications.  Monitoring blood sugar (glucose), maintaining a healthy diet, getting plenty of activity, caring for skin and feet, and other proactive methods are required, the costs of which are greatly covered by the health plan.

Monitoring diet requires an understanding of food labels for sugar and carbohydrates, understanding and selecting healthy alternatives (such as fresh vegetables over junk food and seltzers over sodas), meal planning, smart choices when dining out, scheduling intake in coordination with blood glucose levels, and recording them in conjunction.  This education takes time and effort and is likely written or digital aids.

Monitoring activity/exercise requires not only motivation but know-how.  The type and level of activity/exercise best for one’s body type (height, weight, habitus), understanding how activity/exercise affects sugar levels and knowing warning signs, recognizing activities that are riskier for those with diabetes, scheduling activity in coordination with blood glucose levels, and recording them in conjunction.  This education also takes time and effort and is likely written or digital aids.

Understanding how illness and medications affect blood glucose levels is also essential.

Things to know

To get this training, your loved one must have a written order from their primary care provider, specialist, or qualified non-provider.

Some exceptions apply if group sessions aren’t available in their area, or if the provider says they would benefit more from having individual training sessions.

If your loved one is in a rural area, they may be able to get DSMT services from a non-provider (like a Registered Dietitian) virtually through telehealth.

Diabetes equipment, supplies, and therapeutic shoes

This is a separate benefit. Coverage includes meters and continuous glucose monitors (CGM) that measure blood glucose (blood sugar) and related supplies, including test strips, lancets, lancet holders, and control solutions. Tubing, insertion sets, and insulin for people using insulin pumps, and sensors, transmitters, and receivers for people using CGM are also covered. In addition, one pair of extra-depth or custom shoes and inserts per year for people with specific diabetes-related foot problems are covered.