Medicare Advantage diabetes benefits

We understand the special needs of individuals with diabetes. 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:

• 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.
  • See our dilated retinal exam form. Please take this form with you to your next retinal eye exam. Ask your eye care provider to complete the form and forward the information to your personal doctor. This will help ensure communication of all needed care is completed.
• 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

We offer reduced copays on insulin until you reach the catastrophic stage of Medicare Part D coverage.

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

Find preferred pharmacy and standard retail pharmacy locations.

The insulin savings program applies to the following insulins on our formulary*, including:

* Includes pen injector, injectable solution, injectable suspension, and cartridge.

Diabetic supplies

$0 Diabetic testing supplies (Accu-Chek)

Supplies to monitor your blood glucose are covered at no cost to you. Covered supplies include blood glucose meters, blood glucose test strips, lancet devices and lancets, and glucose-control solutions for checking the accuracy of test strips and meters. Diabetic testing supplies must be Accu-Chek brand in order to be covered.

Continuous glucose monitors

We cover all continuous glucose monitors (CGMs) at no cost to you. You can receive Freestyle Libre or Dexcom CGMs through a retail pharmacy. Other Medicare approved CGMs must be obtained through a medical supply company, Edgepark, or others.

Ask your doctor if you meet Medicare guidelines for the $0 CGM benefit. To receive a CGM, your doctor will need to follow Medicare guidelines and submit a request for approval for your monitor 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 can be purchased at retail pharmacy with Part D.

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

Insulin supplies are covered under the Part D benefit. Covered insulin supplies include syringes, needles, alcohol swabs, and gauze. Insulin supplies are $0 at your local or mail order 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.

Benefits supporting diabetes management

Part C benefits for as low as $0