Medicare diabetes test strips benefit changes Jan. 1

Starting January 1, 2018, Medicare members, both individual and employer group, who use retail or mail-order pharmacies will need to use One Touch (JJHCS) or Breeze/Contour (Bayer) diabetic test strips in order to use their prescription coverage.

Medicare members who fill their prescriptions for test strips at a DME location are not included in this change. 

Affected members will be allowed a one-time transition fill, giving the member time to contact their provider for a new prescription for a covered test strip brand.

New glucose monitors are a plan benefit

Medicare members who change their prescription to One Touch (JJHCS) and Breeze/Contour (Bayer), test strips will need a new blood glucose monitor, which is included as a plan benefit for members who meet Medicare necessity criteria and often provided at no additional cost from a durable medical equipment company (DME), retail pharmacy, the manufacturer and sometimes right from the provider's office.

To learn how to use the new monitor, members can get diabetes self-management training. It's a preventive, in-network benefit included in the plan at no additional cost to the member. 

Notification to our members

We're sending a letter this fall to the approximately 4,600 Priority Health Medicare members affected outlining this benefit change.