Medicare HbA1C Coverage Could Increase Diabetes Screening
Original Article: https://www.medscape.com/viewarticle/medicare-a1c-coverage-boosts-diabetes-screening-prediabetes-2026a1000ww3?form=fpf
The Study
A recent report looks at how changes in Medicare coverage for HbA1C testing could help identify people with prediabetes and type 2 diabetes earlier. Since 2024, Medicare has covered HbA1C testing as part of its diabetes screening benefit, in addition to other glucose tests. Medicare can cover up to two diabetes screening tests within a 12-month period for people who meet certain risk criteria.
Why HbA1C Testing Matters
The HbA1C test estimates a person’s average blood glucose over the previous 2–3 months and does not require fasting. It can identify prediabetes, which is defined as an HbA1C of 5.7%–6.4%, as well as diabetes when the HbA1C reaches the diagnostic range. The American Diabetes Association recognizes HbA1C, fasting plasma glucose, and the oral glucose tolerance test as appropriate tests for screening.
How Coverage Could Help
Before the coverage change, Medicare covered HbA1C testing for monitoring people with established diabetes, but not specifically for screening. Expanding coverage removes a potential financial barrier and gives healthcare providers another convenient way to screen patients who are at risk. Early identification of prediabetes gives patients and clinicians more time to use lifestyle changes and other interventions that can delay or prevent progression to type 2 diabetes.
Why This Matters
Prediabetes is common and often goes undiagnosed. Identifying it through routine screening can connect people with diabetes prevention programs and other support before type 2 diabetes develops. Medicare’s coverage of HbA1C testing may therefore make screening easier and increase opportunities for earlier intervention, although access to screening alone does not guarantee that people will receive follow-up care.
