Medicare will cover nutrition services for specific conditions.
If you have a medical need for nutrition therapy, Medicare Part BMedicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. covers those services.
Unlike some outpatient therapies, you won’t pay the Medicare Part B deductibleA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. or coinsurance for nutrition services.
To have nutrition services covered, you must receive care from a registered dietician.
Medical Nutrition Therapy (MNT) is an evidence-based medical approach to treating certain chronic conditions through an individually tailored nutrition plan. These plans are typically part of a health plan that includes your primary care provider and a registered dietitian.
Medicare Part B generally covers a variety of outpatient care and services. Suppose you need nutrition therapy for a condition like diabetes or kidney disease. In that case, Medicare Part B will cover these services, and you won’t have to pay the usual deductible and coinsurance. Find out more about what nutrition services are covered by Medicare below.
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Medicare’s coverage of Medical Nutrition Therapy is not limited to a particular number of visits. There are some time limitations, though.
In general, your nutrition services covered by Medicare may include things like:
- An initial nutrition and lifestyle assessment
- Individual or group nutrition therapy
- Help with lifestyle modifications to support health for diabetics
- Follow-up assessments to see how well therapies and education are working
While these services aren’t limited to a particular number, they are limited to a total amount of time. Medicare Part B will cover three hours of Medical Nutrition Therapy in the first calendar year it is prescribed and two hours of therapy in the following years. How many appointments this covers depends a lot on the length of your counseling or therapy session.
What are the phases of medical nutrition therapy?
Typically, there are two types of Medical Nutrition Therapy: standard Medical Nutrition Therapy (MNT) and Diabetic Self-Management Training (DSMT). These two types of therapies can be offered alone or together but are usually more effective when used together. Each type of therapy would require a referral.
MNT is offered in four phases, depending on where you are in the process. These phases include:
- Nutrition assessment
- Nutrition diagnosis
- Nutrition monitoring and evaluation
Medicare will pay for a nutritionist, but you and the provider must meet specific criteria to qualify for covered services. Medical Nutrition Therapy is a preventive health service, and therefore Medicare covers 100% of the costs. You won’t be responsible for any copay or deductible as long as you use a doctor that accepts Medicare assignment.
However, Medicare will only cover medical nutrition services for the following conditions:
- Kidney disease
- Kidney transplant in the last 36 months
To ensure Medicare coverage, the provider of these nutrition services must be a registered dietician or nutrition provider that has met specific accreditations and is enrolled as a Medicare provider. The therapy services must help you manage your condition more effectively by choosing the right foods. If you’re on dialysis, coverage includes medical nutrition therapy services.
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Medical Nutrition Therapy is nutrition-based assessment, therapy, and counseling to help with the specific needs presented by certain conditions, like diabetes. With diabetes and kidney disease, the body metabolizes—or uses—energy in different ways and may require different levels of nutrients. Medical Nutrition Therapy can help identify these specific needs and help you find ways to meet them.
General nutrition counseling for weight management or wellness services would not be considered Medical Nutrition Therapy.
Medicare will not cover MNT for obesity, specifically, but if you are obese with diabetes or kidney disease, you may receive nutrition counseling for one of these conditions.
Nutrition counseling for obesity can be covered by Medicare, too, but as a preventive service under standard Medicare Part B coverage. While MNT services are provided under Medicare Part B, they are offered with no coinsurance or deductible costs. Nutrition services focused on obesity or other conditions covered as a treatment service with Medicare Part B would require payment of your standard Medicare Part B deductibles and coinsurance for outpatient services. If the services are considered a part of your preventive care, you may not have to pay any out-of-pocket costs.
What extra benefits and savings do you qualify for?
Yes, but not as part of the MNT coverage. Only diabetes and certain kidney conditions qualify for MNT. You may have general nutrition services covered as part of your preventive care services under Medicare Part B.
If you qualify for MNT, you will have three hours of services covered the first year, and two hours each year you are eligible after that. The number of visits is not counted, but the total time is.
Yes. If you require MNT services for diabetes or qualifying kidney disease, you will have to get a referral to an accredited provider or registered dietician.