Medicare Advantage diabetes benefits

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Our Medicare plans offer benefits that are tailored to the needs of individuals with diabetes

Diabetes management

Do you have diabetes? Make sure you are taking steps to stay healthy:

Struggling to manage your diabetes? Get the help you need by completing our Care Management form to be connected with a nurse case manager. Just choose complex case management and care coordination.

Insulin savings

Important message about what you pay for insulin

You won’t pay more than $35 at a non-preferred pharmacy and $30 at a preferred pharmacy for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you have not paid your deductible.

Getting Help from Medicare - If you chose this plan because you were looking for insulin coverage at $35 a month or less, it is important to know that you may have other options available to you for 2023 at even lower costs because of changes to the Medicare Part D program. 

Contact Medicare, at 1-800- MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for help comparing your options. TTY users should call 1-877-486-2048

Additional resources to help – Contact our Customer Care center at 877-232-7566 (TTY:711) for additional information. 7:30 am-5 pm Monday-Thursday and 8 am-4:30 pm (year-round).

Does insulin play a role in managing your diabetes? We can help. Our plans offer reduced copays on insulin until you reach the catastrophic stage of Medicare Part D coverage. We offer:

  • $30 insulin fills at preferred pharmacy locations.
  • $35 insulin fills at standard retail pharmacies.

Find preferred pharmacy and standard retail pharmacy locations.

Our insulin savings program applies to all insulins on the formulary*, including:

  • Novolin R 100 unit/ml
  • Toujeo 300 unit/ml
  • Toujeo 100 unit/ml
  • Tresiba 100 unit/ml
  • Tresiba 200 unit/ml
  • Novolin (70/20) mix 100unit/ml
  • Insulin Aspart Human 100 unit/ml
  • Fiasp 100 unit/ml
  • Humulin R 500 unit/ml
  • Levemir 100 unit/ml
  • Novolog 100 unit/ml
  • Lantus 100 unit/ml
  • Xultrophy 100 unit-3.5ml
  • Soliqua 100 unit-0.033mg/ml
  • Insulin Aspart Protamin (70/30) mix 100unit/ml 

* Includes Pen Injector, Injectable Solution, Injectable Suspension and Cartridge.

Diabetic supplies

$0 Diabetic supplies

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.

Continuous glucose monitors

We cover all Continuous Glucose Monitors (CGMs) at $0. You can receive Freestyle libre or Dexcom CGMs through your  in-network Retail pharmacy. Other CGMs must be obtained through a medical supply company, Edpepark or others.

Ask your doctor if you meet Medicare guidelines for the $0 continuous glucose monitor 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

Insulin pumps covered by our plan are Minimed, T Slim and Omnipod. Minimed and T Slim are covered under the durable medical equipment (DME) benefit. You will pay 20% coinsurance in-network for insulin pumps. Omnipod supplies can be purchased at a retail pharmacy at your 20% Part B copay.

To receive an insulin pump, your doctor needs to follow Medicare guidelines, and submit a request for T Slim or Minimed for your insulin pump to be administered.

Insulin supplies

Insulin supplies are covered under the Part D benefit. Covered insulin supplies include syringes, needles, alcohol swabs and gauze. Insulin supplies can be purchased a $0 at your in-network or mail order pharmacy.

Therapeutic shoes and inserts

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.

Ask your doctor if you meet Medicare guidelines for the $0 continuous glucose monitor benefit.

Benefits supporting diabetes management

$0 Part C benefits

  • PCP visits
  • Outpatient mental health
  • Labs
  • Diabetic supplies
  • Kidney disease education

Additional benefits

View our Medicare disclaimer.
Updated: 1/30/23