Medicare Advantage diabetes benefits

senior man smiling with young female nurse outside

We understand the special needs individuals with diabetes face. 

Our Medicare Advantage plans offer specific benefits geared toward those needs.

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

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 N 100 unit/ml
  • Novolin R 100 unit/ml
  • Toujeo 300 unit/ml
  • Toujeo 100 unit/ml
  • Tresiba 100 unit/ml
  • Tresiba 200 unit/ml
  • Fiasp 100 unit/ml
  • Humulin R 500 unit/ml
  • Levemir 100 unit/ml
  • Novolog 100 unit/ml
  • Lantus 100 unit/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 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

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

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.

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: 3/8/22