The Medicare Advantage plans listed below will be
implementing coverage changes for their enrollees’ diabetic supply needs. For
this plan year, the plans will continue to only cover LifeScan, Inc., OneTouch®
or Roche Diagnostics, ACCU-CHEK® diabetic glucometers and test strips. One
glucometer will be covered every 180 days.
The plans will only cover Roche, Prodigy, Owen Mumford,
Perrigo, Lifescan and Good Neighbor lancets.
A transition fill will be available for diabetic supplies
after Jan, 1, 2017 to enrollees who haven’t received a new prescription of
diabetic supply products. A transition letter will be sent to the patient
containing information on the covered alternatives as well as the prior
authorization process. Prescribers should call 800.338.6180 to request a
coverage exception. Pharmacies should check their supply of these covered
products and watch for point-of-sale messaging that will indicate quantity
limits or brand requirements. If there are any questions, pharmacies may
contact the Express Scripts help desk at 800.922.1557.
*Please see attached PDF for more information.