We understand that, if you are diabetic, you could use a little extra help. Our Medicare Advantage plans offer specific benefits geared toward those needs.
If you have diabetes, make sure you are taking steps to stay healthy. These are approved and covered by your health plan:
Struggling to manage your diabetes? We can help you! Complete our Care Management form to be connected with a nurse who will provide you with the support you need. Just select complex case management and care coordination.
Does insulin play a role in managing your diabetes? We can help. Our plans offer reduced copays on insulin even through the donut hole. We offer:
Our insulin savings program applies to all insulins on the prescription drug list/formulary*, including:
* Includes pen injector, injectable solution, injectable suspension and cartridge.
Supplies to monitor your blood glucose are covered at $0. Covered supplies include blood glucose monitors, blood glucose test strips, lancet devices and lancets, and glucose-control solutions for checking the accuracy of test strips and monitors. Diabetic testing supplies must be Accu-Chek brand in order to be covered.
We cover Freestyle Libre and Dexcom continuous glucose monitors (CGM) at $0. You can receive your CGM through retail pharmacies or Edgepark, a medical supply company.
Ask your doctor if you meet Medicare guidelines for the $0 CGM benefit. To receive a CGM, your doctor needs to follow Medicare guidelines, and submit a request for approval for it to be administered.
Insulin pumps covered by our plan are Minimed, T Slim and Omnipod. Minimed and TSlim are covered under the durable medical equipment (DME) benefit. You will pay 20% coinsurance in-network for insulin pumps. Omnipod supplies are part of your Part D plan and can be purchased at a retail pharmacy at tier 3.
To receive an insulin pump, your doctor needs to follow Medicare guidelines, and submit a request for approval for TSlim or Minimed for your insulin pump to be administered.
Insulin supplies are covered under the Part D benefit. Covered insulin supplies include syringes, needles, alcohol swabs and gauze. Insulin supplies are on Tier 2 of our formulary. The Tier 2 copay is $5 at preferred retail pharmacies and $12 at standard retail pharmacies.
For people with diabetes who have severe diabetic foot disease, we cover one pair of therapeutic custom-molded shoes or depth shoes per calendar year. This coverage includes fitting. You will pay 20% coinsurance in-network for therapeutic shoes and inserts. Therapeutic shoes and inserts are only available through NPS Foot Health.