New legislation makes diabetes prevention more accessible for seniors through virtual participation and expanded eligibility

Medicare beneficiaries at risk for developing Type 2 diabetes will soon have easier access to prevention services, thanks to changes in the Consolidated Appropriations Act of 2026.

The legislation expands the Medicare Diabetes Prevention Program (MDPP) by extending the ability through 2029 for participants to join virtually and removing the previous one-time lifetime limit. These updates are intended to make the program more accessible, especially for seniors who face mobility challenges, transportation barriers, or other health issues that make in-person attendance difficult.

Under the new law, virtual diabetes prevention programs recognized by the Centers for Disease Control and Prevention (CDC) can participate in the MDPP on a trial basis through the end of 2029. The Centers for Medicare and Medicaid Services (CMS) has also updated its rules to allow digital health providers to be reimbursed for offering the program online.

The need for expanded access is significant. Some sources estimate that almost half of adults age 65 and older have prediabetes, and millions of Medicare beneficiaries already have diabetes. Preventing or delaying the disease can lower the risk of serious complications such as heart disease, kidney failure, and vision loss.

Despite its potential benefits, participation in the program has been extremely low—just 4,850 total enrollees to date. According to medical trade associations, limited access to in-person programs, particularly in rural areas and small towns, has kept many eligible individuals from enrolling. Allowing virtual access removes that barrier and may make the program more accessible for people over 65.

Another important change removes the restriction that limited participants to participating in the program only once. Beneficiaries who need additional support in the future will now be able to enroll again.

Seniors can still choose to attend the program in person if they prefer, but the addition of a virtual option may significantly broaden participation.

How the MDPP program works

The MDPP is a structured lifestyle program designed to help people with prediabetes reduce their risk of developing Type 2 diabetes. It is covered under Medicare Part B for eligible beneficiaries who have not been diagnosed with type 1 or type 2 diabetes or End-Stage Renal Disease (ESRD), and who meet certain medical criteria related to body mass index (BMI) and blood sugar levels.

Key features of the program include:

• The program typically lasts 12 months.
• Participants attend 16 weekly sessions during the first six months.
• After the initial phase, participants attend six monthly maintenance sessions.
• Sessions are led by trained lifestyle coaches who teach strategies for healthy eating, physical activity and weight management.
• Participants aim to lose about 5% of their body weight through healthier habits.
• Coaches help participants monitor their weight and activity levels.
• In-person and live online sessions are conducted in groups, allowing participants to share challenges and encouragement. Participants may also choose to participate virtually through non-live online sessions as an individual.

A doctor must confirm that a patient meets the clinical criteria before enrolling.

For more information about MDPP, visit Medicare.gov

Why seniors should consider enrolling

Type 2 diabetes is one of the most common chronic conditions affecting older Americans, but in many cases, it can be prevented or delayed through lifestyle changes.

The new virtual option means many seniors can now participate from home using a computer, tablet or smartphone. For those with limited mobility, caregiving responsibilities or transportation challenges, that convenience could make the difference between enrolling and not enrolling.

If you have prediabetes or are at risk for developing diabetes, talk with your doctor about whether you qualify for the MDPP.