Medicare Advantage diabetes benefits

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:

• Get an HbA1c test at least twice a year to check your average blood glucose level for the past two to three months.
• Get an LDL test when you are first diagnosed with diabetes to check your level of "bad" cholesterol, and repeat testing as recommended by your doctor.
• Get diabetic kidney disease testing.
• Get an eye exam which may include a dilated retinal exam.
• Get a regular foot exam.
• Eat a healthy diet and exercise regularly.
• Stay active. Register for One Pass.
  
  

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

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:

* 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