If you are on Medicare in Georgia and your doctor says you are at risk for diabetes, your blood sugar test is free, and you can get up to two of them a year.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors This guide explains who counts as at risk, which tests Medicare pays for, how often, and the one detail that decides whether you pay nothing or get a bill.
The benefit is the Medicare diabetes screening benefit, a preventive test that Medicare Part B covers at $0 for beneficiaries with diabetes risk factors. Almost everyone on Medicare qualifies, because being 65 or older is itself a risk factor.
In This Guide
- Does Medicare Cover Diabetes Screening in Georgia?
- Who Qualifies for a Free Screening?
- Which Test Will You Get?
- How Often Will Medicare Pay?
- What Will It Cost You?
- How to Get Your Free Diabetes Screening
- What If Your Result Shows Prediabetes?
- Why Georgia Medicare Diabetes Screening Matters
- Frequently Asked Questions
- Where to Get Help in Georgia
- Learn More
Does Medicare Cover Diabetes Screening in Georgia?
Yes. Medicare Part B covers diabetes screening tests for beneficiaries who are at risk for diabetes, and you pay $0 when your provider accepts Medicare assignment: no Part B deductible and no coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors Georgia works exactly like the rest of the country here, because diabetes screening is a federal Medicare benefit, not a state program.
The benefit is written into federal Medicare law at Section 1861(yy) and spelled out by the Centers for Medicare & Medicaid Services (CMS) in National Coverage Determination 190.21. The reason you pay nothing is a separate rule, Section 4104 of the Affordable Care Act, which waived cost-sharing for a set of Medicare preventive services, diabetes screening among them.Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jul 23, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
The one detail that matters most is how the test is billed. When it is ordered as a screening (for someone who does not already have diabetes), it is free. When the same blood test is ordered to diagnose or monitor diabetes you already have, it falls under regular Part B cost-sharing. That distinction is covered in What Will It Cost You? below.
Who Qualifies for a Free Screening?
Medicare covers the screening at $0 for beneficiaries who have at least one recognized diabetes risk factor.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors The qualifying risk factors are:
- Age 65 or older
- High blood pressure (hypertension)
- Abnormal cholesterol or triglycerides (dyslipidemia)
- Obesity
- A history of gestational diabetes (diabetes during pregnancy)
- Having delivered a baby weighing more than 9 pounds
- A family history of diabetes (parent, sibling, or child)
- Membership in a higher-risk racial or ethnic group
In practice, almost everyone on Medicare qualifies, because being 65 or older is itself a qualifying risk factor. Add the high rates of high blood pressure, high cholesterol, and obesity among older adults, and very few Medicare beneficiaries fall outside the benefit. If you are unsure, your primary care provider can confirm which risk factor applies to you and note it in your record, which is what allows the test to be billed as a covered screening.
Which Test Will You Get?
Medicare covers three blood tests for diabetes screening. Your provider chooses the one that fits your situation. For most older adults, that is the HbA1c or the fasting blood sugar test, because they are simpler than the glucose tolerance test.
| Test | What it measures | Do you fast? | Best for |
|---|---|---|---|
| HbA1c (A1c) | Your average blood sugar over the past 2 to 3 months | No | Most people; convenient, can be drawn at your visit |
| Fasting plasma glucose (FPG) | Your blood sugar after an overnight fast | Yes, about 8 hours | A straightforward, low-cost test when you can fast |
| Oral glucose tolerance test (OGTT) | Blood sugar before and 2 hours after a sugary drink | Yes | Specific cases; takes several hours, less common |
The HbA1c is popular because it needs no fasting and can be drawn during the same visit. The fasting glucose test is simple but requires you to skip food overnight. The glucose tolerance test is the most sensitive but takes a few hours and multiple blood draws, so it is used less often for routine screening. All three are covered at $0 when ordered as a screening.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors
How Often Will Medicare Pay?
Medicare covers up to two diabetes screening tests per year for beneficiaries who are at risk, counted within 12 months of your most recent screening.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors That is the headline number to remember: two free screenings a year if you have a risk factor and have not been diagnosed with diabetes.
Once you are diagnosed with diabetes, ongoing blood sugar tests such as A1c are no longer "screening." They become diagnostic monitoring, which is still covered but under regular Part B cost-sharing rather than the free preventive benefit. CMS can adjust the covered frequency over time, so if you are timing a second test close to the 12-month mark, confirm the current limit on the Medicare diabetes screening page or with your provider.
What Will It Cost You?
For a covered screening, the answer is simple: nothing. Medicare pays 100 percent of the approved amount and waives both the deductible and the coinsurance, as long as your provider accepts Medicare assignment. The cost only appears when a blood sugar test is ordered for a different reason.
| Situation | How it is billed | What you pay |
|---|---|---|
| At-risk, no diabetes diagnosis, ordered as screening | Preventive screening | $0 |
| You already have diabetes; test monitors it | Diagnostic testing | Part B deductible ($283 in 2026), then 20% of the approved amount |
| Symptoms being worked up, not a routine screen | Diagnostic testing | Part B deductible, then 20% coinsurance |
The deductible and coinsurance in the diagnostic rows are the standard 2026 Part B figures: a $283 annual deductible, then 20 percent of the Medicare-approved amount.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors If you have a Medicare Supplement (Medigap) plan, it may cover that coinsurance. The practical takeaway: make sure a test meant as a screening is actually ordered and coded as a screening, so it lands in the free row.
How to Get Your Free Diabetes Screening
You do not need a special appointment. The easiest path is to fold the screening into a visit you already have. Here is how a Georgia beneficiary gets it done.
Raise it at your yearly wellness visit
Medicare covers a yearly Wellness visit and the one-time Welcome to Medicare visit at no cost, and both are natural moments to order diabetes screening. Ask your primary care provider whether you are due.
Confirm a risk factor is on record
The test is covered because you have a qualifying risk factor. Your provider notes it (age 65+, high blood pressure, obesity, family history, and so on) so the claim is paid as a screening.
Ask that it be ordered as a screening
This is the step that keeps it free. A screening is billed with the screening code (Z13.1), not a diagnostic code. Say plainly that you want it as a preventive screening.
Check that your provider accepts assignment
The $0 cost applies when your provider and lab accept Medicare assignment. Most primary care offices, hospital labs, and Georgia Federally Qualified Health Centers (FQHCs) do.
If the result shows prediabetes, ask about MDPP
A prediabetes result can qualify you for the Medicare Diabetes Prevention Program, a free lifestyle program described below. Ask for a referral.
What If Your Result Shows Prediabetes?
Prediabetes means your blood sugar is higher than normal but not yet in the diabetes range. It is common, and catching it early is the point of screening, because prediabetes can often be reversed or slowed.
If your screening comes back in the prediabetes range, ask your provider about the Medicare Diabetes Prevention Program (MDPP). MDPP is a structured, CDC-recognized lifestyle-change program, run by trained coaches, that helps you lose weight and change habits to prevent type 2 diabetes. Medicare covers it at $0, with no deductible.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors For years, MDPP was a once-in-a-lifetime benefit, but for 2026 through 2029 that limit has been lifted, so eligible beneficiaries can enroll more than once.
If a later test shows you have crossed into diabetes, Medicare's coverage shifts to managing it. Two services help you learn to live with the diagnosis:
- Diabetes Self-Management Training (DSMT), up to 10 hours of initial training plus 2 hours a year after that. DSMT is not a free preventive service; you pay the Part B deductible and 20 percent coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors
- Medical Nutrition Therapy (MNT), counseling from a registered dietitian, generally 3 hours in the first year and 2 hours a year after, on a doctor's referral. For people with diabetes, MNT is covered at $0.Centers for Medicare & Medicaid Services. (n.d.). Continuous glucose monitors. medicare.gov. Retrieved Jul 15, 2026, from https://www.medicare.gov/coverage/continuous-glucose-monitors
Why Georgia Medicare Diabetes Screening Matters
Diabetes is more common in Georgia than in much of the country, and it becomes more common with age, so most Georgians on Medicare carry at least one risk factor that makes screening free. The burden falls hardest in rural south and southwest Georgia and in parts of metro Atlanta with fewer health resources, the same regions where diabetes complications, heart and kidney disease, vision loss, and amputations run high.
Because the test costs nothing and catches problems early, screening is one of the most useful free benefits Medicare offers Georgia beneficiaries. For current state-level diabetes figures, the Georgia Department of Public Health publishes prevalence data through its chronic disease programs.
Frequently Asked Questions
Does Medicare cover a diabetes test in Georgia?
Yes. Medicare Part B covers diabetes screening for beneficiaries with a diabetes risk factor, and you pay $0 when your provider accepts Medicare assignment. Because age 65 or older is itself a risk factor, most Medicare beneficiaries qualify.
How often does Medicare cover an A1c or blood sugar screening?
Up to two screening tests per year for at-risk beneficiaries, counted within 12 months of your most recent screening. Once you are diagnosed with diabetes, blood sugar tests become diagnostic monitoring under regular Part B cost-sharing rather than the free screening benefit.
Is the A1c test free under Medicare?
When it is ordered as a preventive screening for an at-risk person without diabetes, yes, the HbA1c is covered at $0. If the same test is ordered to monitor diabetes you already have, it is billed as diagnostic and you pay the Part B deductible and 20 percent coinsurance.
What is the difference between a screening and a diagnostic test?
A screening is for someone at risk who has not been diagnosed with diabetes, and it is free. A diagnostic test is for someone with symptoms or an existing diagnosis, and it carries the normal Part B deductible and 20 percent coinsurance. The billing code your provider uses (a screening code versus a diagnostic code) is what decides which applies, so ask for it to be ordered as a screening.
What happens if my screening shows prediabetes?
Your provider talks through the result and may refer you to the Medicare Diabetes Prevention Program (MDPP), a free lifestyle-change program. You would also continue getting covered follow-up screenings. If a later test shows diabetes, coverage shifts to managing it, including diabetes education and nutrition counseling.
Does this work the same way in a Medicare Advantage plan?
Yes. Medicare Advantage (Part C) plans must cover the same preventive services as Original Medicare, including diabetes screening at $0, when you use an in-network provider. Check your plan's network before scheduling.
Where to Get Help in Georgia
Free, unbiased help with Medicare questions in Georgia comes first from GeorgiaCares, the state's Medicare counseling program. The resources below can answer coverage questions, help with a wrongly billed screening, or connect you to diabetes programs.
Learn More
Find personalized help understanding your Georgia Medicare diabetes screening benefit at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.