Affordable Care Act

Affordable Care Act

How will the Affordable Care Act affect people with diabetes and those who provide diabetes care?

For those who already have insurance through an employer or for those who purchase new coverage in the Health Insurance Marketplace, certain "essential health benefits" will have to be covered. Included in the list of essential benefits is preventive health services and chronic disease management. People who are already diagnosed with diabetes cannot be denied coverage for their pre-existing condition.

Covered Preventive Care Services:

These services will NOT be subject to a deductible or copay.

  • Diabetes screening will be covered for those with high blood pressure
  • Screening of pregnant women for gestational diabetes
  • MNT for those with diabetes
  • Annual wellness visit for those covered by Medicare

Diabetes Self-Management Training:

DSMT is not specifically mentioned in the Affordable Care Act as a free preventive service, but would be considered an important part of chronic disease management services. It is believed that most plans within the new Health Insurance Marketplace will cover DSMT and MNT with a patient copay. Medicare already covers DSMT provided by a recognized credentialed program.

Numerous resources are available from the Academy of Nutrition and Dietetics concerning billing and reimbursement for the services of a registered dietitian. Watch for updates in the Members Only- Coding, Coverage and Compliance section of the AND website.