Our Medicare Advantage plans offer specific benefits geared toward those needs.
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.
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:
Find preferred pharmacy and standard retail pharmacy locations.
Our insulin savings program applies to all insulins on the 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 continuous glucose monitor through retail pharmacies or Edgepark, a medical supply company.
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 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 your retail pharmacy at tier 3.
To receive an insulin pump, your doctor needs to follow Medicare guidelines, and submit a request 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.
Ask your doctor if you meet Medicare guidelines for the $0 continuous glucose monitor benefit.