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We all know the basics of how to lose weight. Say it with me… “it takes proper exercise and a healthy diet”.
Of course, it’s not quite as simple in practice. When it comes to your diet, health awareness and education are very helpful. And if you cannot get it done by yourself, it is alright to ask for assistance from a dietitian.
So a common question many people have is, “does Medicare cover dietitians?” In this article, we answer the question in clear, plain English. You will also find the average costs of dietitians, as well as other helpful info.
Does Medicare Cover Dietitians?
The short answer is yes; Medicare will cover the cost of a dietitian. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your dietitian. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for dietitians. Coverage for a dietitian is under Part B.
Medical Nutrition Therapy
Medicare Part B only pays for Medical Nutritional Therapy if you are suffering from diabetes, kidney disease, and/or undergoing dialysis. They also cover dietitians if you had a kidney transplant within the last three years and if your healthcare provider orders it.
Medicare Part B will pay for Medical Nutrition Therapy provided by a dietitian or any other nutrition expert if your healthcare provider prescribes it.
There are a number of services you can get with this therapy. It often starts with an assessment of your diet, lifestyle, etc. It also often includes the dietitian developing an eating plan for you.
If Medicare does provide coverage for your Medical Nutrition Therapy, they will cover three hours of therapy for the first year and two hours for the following years.
Medicare Part B will cover 100% of the costs of Medical Nutrition Therapy. That is because Medical Nutrition Therapy is considered a preventive health service.
Medical Nutritional Therapy for Obesity
Medicare also provides coverage for Medical Nutritional Therapy for Obesity. They will cover Medical Nutritional Therapy for Obesity if you have a body mass index (BMI) of 30 or above and if you are suffering from a medical condition caused by obesity.
They will only cover Medical Nutritional Therapy for Obesity if the therapy takes place in a primary care setting, such as a doctor’s office. Medicare pays 100% of the cost of Medical Nutritional Therapy for Obesity. They will cover one session per week for the first month and an appointment every other week for the five months after that.
Once you lose around 3 kg in the first six months, Medicare will cover one session per month for another six months. If you have not lost at least 6.6 pounds within the first six months, you can continue to have your therapy. Still, you will have to wait for another six months for Medicare to provide coverage.
Medicare Advantage plans (Medicare Part C) also provides coverage for dietitians as they cover everything Original Medicare covers. However, out-of-pocket costs will vary depending on the plan provided by the plan providers. But you will not have any deductible, copay, or coinsurance for Medical Nutritional Therapy if you use an in-network doctor.
What Are The Rates Of Dietitians?
The typical rates vary depending on where you live, the type of services you need and the experience level of the dietitian you go to. But, on average, you can figure that it will cost between $70 to $150 per visit for their services.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover chest x rays?