Does Medicare cover nutrition counseling?

Who is eligible for Medicare’s nutrition counseling benefit?

The benefit is available for people in at least one of three categories:

• A diabetes diagnosis.
• Impaired kidney function that doesn’t require dialysis or a transplant, including chronic kidney disease stages 3 and 4. For patients with end stage renal disease on dialysis, the benefit is part of their dialysis coverage.
• Recipient of a kidney transplant within the past 36 months.  

A proposal in Congress would expand the coverage to additional chronic conditions.

To qualify, a doctor must refer you for services. It can’t be a physician’s assistant or nurse practitioner, Prest says.

“As long as your doctor is making that referral to a dietitian who is a provider under Medicare, it should be no cost to you,” she says. Consult your primary care physician or your kidney or diabetes doctor for a recommendation.

You can find a dietitian through the academy’s eatright.org website under Find a nutrition expert.

“There are dietitians who specialize in treating individuals with kidney disease, holding a special certification in renal nutrition,” Steiber says. Two sources include the National Kidney Foundation’s Kidney Dietitian Directory and RenalNutrition.org.

Prest warns that joining the list is voluntary, so not all dieticians accepting Medicare may be on it. When contacting a source, ask if they take Medicare and are eligible to participate in Medicare's medical nutrition therapy program. Telehealth visits are also an option if you live in a rural area.

“Always be your own advocate and ask questions,” Prest says. “Don’t be afraid to ask your provider for a referral.”

Does Medicare cover other programs with nutrition benefits?

Yes. Part B covers nutrition-related services for people with health conditions such as diabetes or obesity, including:

Diabetes self-management training. Consisting of one hour of individual training followed by up to nine hours of group training, this program helps those diagnosed with diabetes learn to monitor their blood sugar, follow tips for eating healthy and physical activity, manage prescriptions and reduce their risks. Afterward, you get two hours of follow-up training each year.

You must have a written order from your doctor or other health care provider and can be eligible for both diabetes self-management training and Medicare nutrition therapy, but they can’t be billed on the same date. Once you meet the Part B deductible, you’ll pay 20 percent of the Medicare-approved amount for the training program.

Medicare diabetes prevention program. This yearlong diabetes prevention program helps people with prediabetes avoid or delay developing the disease. A coach works with you to increase your level of exercise, change your diet and help you control your weight.

To qualify, you must have a body mass index (BMI) of 25 or higher, 23 or higher for someone of Asian descent, and meet certain blood sugar test requirements. The preventive benefit isn’t subject to the Part B deductible or 20 percent coinsurance.

Weight-loss counseling. Medicare Part B also covers weight-loss counseling by a primary care provider to help you lose weight through diet and exercise. The program includes an initial obesity screening, dietary assessment and behavioral therapy.

To qualify, you must have a BMI of 30 or higher. It too is considered a free preventive benefit.

Keep in mind

Private Medicare Advantage plans must offer the same coverage as Medicare Part B, including nutrition counseling programs. You may find some plans with additional benefits, including:

Healthy foods benefit, also called a grocery allowance, that gives people with certain chronic conditions extra money, usually through a flex card, to buy healthy food and produce on a monthly or quarterly basis. KFF, formerly the Kaiser Family Foundation, reports that 13.9. percent of regular Medicare Advantage plans and 60 percent of special needs plans offer food and produce benefits in 2024.

Meal delivery. KFF also reports that 72 percent of regular Medicare Advantage plans and 75 percent of special needs plans offer meal delivery benefits in 2024. These are usually available for up to four weeks immediately after an inpatient hospital or skilled nursing facility stay. Unlike the healthy foods benefit, meal deliveries aren’t limited to people with chronic conditions.

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