Objective: To examine the outcomes of a Medicare population who participated in a program combining digital health with human coaching for diabetes risk reduction. Method: People at risk for diabetes enrolled in a program combining digital health with human coaching. Participation and health outcomes were examined at 16 weeks and 6 and 12 months. Results: A total of 501 participants enrolled; 92% completed at least nine of 16 core lessons. Participants averaged 19 of 31 possible opportunities for weekly program engagement. At 12 months, participants lost 7.5% ( SD = 7.8%) of initial body weight; among participants with clinical data, glucose control improved (glycosylated hemoglobin [HbA1c] change = −0.14%, p = .001) and total cholesterol decreased (−7.08 mg/dL, p = .008). Self-reported well-being, depression, and self-care improved ( p < .0001). Discussion: This Medicare population demonstrated sustained program engagement and improved weight, health, and well-being. The findings support digital programs with human coaching for reducing chronic disease risk among older adults.