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October 24, 2019

Medicare's Nutrition Benefit: 7 Things to Know

In certain circumstances, Medicare B plans will pay for medical nutrition therapy (MNT), and this post will share seven things that you should know about this benefit, including answers to some frequently asked questions on the subject.

#1 A doctor must refer you before you can receive medical nutrition therapy (MNT).

This is a must!

#2 Services would be provided by a registered dietician or nutrition professional.

Certain requirements must be met by the professionals who would provide you with these nutrition-related benefits, and you must use a qualifying professional. If you live in a rural area, you may be able to receive MNT through telehealth services, where a registered dietician or nutrition professional from another location would provide you with medical nutrition therapy services.

#3 Medical nutrition therapy is provided to people with certain medical conditions.

These medical conditions include diabetes or kidney disease or if you’ve had a kidney transplant within the last 36 months. These services can include:

  • an initial assessment where issues related to nutrition and lifestyle are observed
  • individual and/or group nutritional counseling services
  • follow-up visits to monitor your progress

#4 How much do medical nutrition therapy services cost?

If you’re approved for these services, Medicare B would cover medical nutrition therapy — which means you’d pay nothing. However, your doctor may recommend certain services that go beyond those typically covered by Medicare. In that case, you may need to pay either in part or in its entirety.

Medicare provides a service to check your coverage online. You’ll see a box reading, “Is my test, item, or service covered?” You can then enter what your doctor is recommending and click “Go” for results. It also makes sense to ask your doctor about why he or she is recommending certain services and also ask about Medicare coverage.

Typically, Medicare will pay for three hours of nutritional counseling during year one, with two hours in subsequent years. If your doctor believes you can benefit from more counseling, he or she can file an appeal for more medical nutritional therapy.

If you only have Medicare A, you will probably be responsible for paying the costs yourself.

#5 Are people taking advantage of this service?

AARP notes that, although there are an estimated 15 million people on Medicare who have diabetes or kidney disease — people who would likely be eligible for the nutritional counseling benefits — only about 100,000 people received this counseling in 2017. The article notes that this figure does not include the people enrolled in private Medicare Advantage plans, but there are clearly still large numbers of qualified people not yet receiving them.

#6 Are there significant benefits to this nutritional counseling?

The reality is that Congress approved this benefit because studies showed improved health outcomes, including fewer complications, when nutritional counseling was given to people with diabetes or kidney disease. This benefit has been available for Medicare B patients since 2002 and, under the Affordable Care Act, it’s also become available to a greater number of qualified people since 2011.

Health experts have noted how Medicare can save money through this program because it can help to prevent costly complications from occurring.

#7 Can I get these benefits if I don’t have diabetes or kidney disease?

If you have a Medicare Advantage plan, check to see if yours covers home meal delivery or other options to provide you with healthy food. Your plan may have added these nutrition benefits in 2019.

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