Medicare Advantage diabetes benefits

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Dean Health Plan understands the special needs of individuals with diabetes. Our Medicare Advantage plans offer specific benefits geared toward those needs. 

Important message about what you pay for insulin

You won't pay more than $35 at a non-preferred pharmacy or $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. 

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 1-877-232-7566 (TTY:711) [8 am-8 pm Mondays-Fridays (year-round) and weekends (Oct. 1-March 31).

 

Diabetes management

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

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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:

  • Fiasp 100 unit/ml
  • Humulin R 500 unit/ml
  • Insulin Aspart Human 100unit/ml
  • Insulin Apart Protamine (70/30) mix 100unit/ml
  • Lantus 100 unit/ml
  • Levemir 100 unit/ml
  • Novolin 70/30 mix 100unit/ml
  • Novolin N 100 unit/ml
  • Novolin R 100 unit/ml
  • Novolog 100 unit/ml
  • Soliqua 100unit-0.33mg/ml
  • Toujeo 300 unit/ml
  • Toujeo 100 unit/ml
  • Tresiba 100 unit/ml
  • Tresiba 200 unit/ml
  • Xultrophy 100 unit-3.6ml

* 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 $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 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 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 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 per calendar year 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

$0 Part C benefits