Mercado de seguros médicos

UnitedHealthcare Colorado Option Individual & Family plans cover the below listed diabetic supplies at no additional cost to you when provided by an in-network provider. Even if your plan has a deductible and you haven’t met it yet, your cost share is still $0 for these diabetic supplies.

Covered Diabetic Supplies

Insulin Pumps

Covered by both Pharmacy and Medical
Farmacia: your pharmacy benefit covers Omnipod 5, but you must get a prior authorization before your plan covers it. Servicios médicos: your medical benefit covers insulin pumps through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you.

Syringes & Needles

Covered by both Pharmacy and Medical
Farmacia: your pharmacy benefit covers various syringes and needles to administer your insulin. Servicios médicos: your medical benefit covers various syringes and needles to administer your insulin through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you.

Blood Glucose Monitors and Test Strips

Covered by both Pharmacy and Medical

Farmacia

Glucose monitors

  • Accu-Chek® Guide
  • Accu-Chek® Guide Me
  • OneTouch® Ultra® 2
  • OneTouch Verio Flex®
  • Prodigy Autocode® (Requires prior authorization)
  • Prodigy Autocode® Blood Glucose Monitoring/Talking (Requires Prior Authorization)
  • Prodigy Autocode® Blood Glucose Monitoring System (Requires Prior Authorization)
  • Prodigy® No Coding Blood Glucose (Requires Prior Authorization)
  • Prodigy Pocket® Blood Glucose Meter Kit (Requires Prior Authorization)
  • Prodigy Voice® Blood Glucose Meter Kit (Requires Prior Authorization)

Test strips

  • Accu-Chek® Aviva Plus
  • Accu-Chek® Guide
  • Accu-Chek® SmartView
  • OneTouch® Ultra®
  • OneTouch Verio®
  • Prodigy® No Coding (Requires prior authorization)

Servicios médicos: your medical benefit covers blood glucose monitors and test strips through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you.

 

Continuous Glucose Monitors (CGM)

Covered by both Pharmacy and Medical

Farmacia: your pharmacy benefit covers the following CGMs, but you must get a prior authorization before your plan covers it:

  • Dexcom G6
  • Dexcom G7
  • Free Style Libre
Servicios médicos: your medical benefit covers continuous glucose monitors (CGM) through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you.

Other Covered Diabetic Supplies

Covered by both Pharmacy and Medical

Farmacia: your pharmacy benefit covers items such as:

  • Alcohol pads
  • Control solutions
  • Glucose tablets
  • Ketone test strips
  • Lancets
  • Lancing devices
  • Sharps container
  • Urine test strips

Servicios médicos: your medical benefit covers other diabetic supplies through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available for items such as:

  • Alcohol pads
  • Control solutions
  • Glucose tablets
  • Ketone test strips
  • Lancets
  • Lancing devices
  • Sharps container
  • Urine test strips

Where can I learn more about Prescription Drug Benefits?

  • To learn more about a product on this list, check your Prescription Drug List for tier information, coverage rules, and any limits, such as quantity limits.
  • To find a network pharmacy, check the Provider Directory. Have your network pharmacy submit a claim to Optum Rx (our pharmacy service provider) to process the claim under your pharmacy benefit.

Where can I learn more about Durable Medical Equipment (DME) products?

To learn more about specific Durable Medical Equipment (DME) products covered through your medical benefit, please reach out to one of our DME Providers listed below to obtain information about products available to you:

Autorización previa

What if my diabetic supplies require prior authorization?

If your plan requires prior authorization for a diabetic supply, your healthcare provider (doctor, nurse practitioner, etc.) will give us information about your diagnosis, treatment history and other relevant information to request prior authorization. If the prior authorization request is approved, you will pay a $0 cost share, not subject to a deductible.

To request a prior authorization:

  • Health care providers:
    • Pharmacy Benefit: Please contact OptumRx by calling 1‐800‐711‐4555 or submit an online prior authorization request at: professional.optumrx.com.
    • Medical Benefit: Please submit an online prior authorization request through the provider portal.