Diabetes DME Coverage

Comprehensive Diabetes Disease Therapy Management Program

Glucometers, test strips, and lancets are classified as durable medical equipment (DME). IEHP provides its Medi-Cal and Dual Choice Medicare Members with glucometers and testing supplies through our Diabetes Disease Therapy Management Program (without prior authorization).

The Diabetes Disease Management Program is managed by WeCare Pharmacy and the following benefits apply:
 
The IEHP exclusive preferred diabetes meter and test strip is the OneTouch Verio Flex® meter and the OneTouch Verio® test strips

OneTouch Verio Flex®: Maximum 1 glucometer every 24 months

Test Strips

  • Insulin dependent: 450 test strips per 90 days
  • Non-insulin dependent: 200 test strips per 90 days
  • Maximum of a 3 month supply at a time
Lancet Device
  • Maximum 1 device every 6 months
For Members who do not want to receive comprehensive diabetes management services, Members can receive testing supplies through their community pharmacy (upon an approved prior authorization) and the following benefits apply:

TrueMetrix
®: Maximum 1 glucometer every 24 months

Test Strips

  • Insulin dependent: 300 test strips per 90 days
  • Non-insulin dependent: 100 test strips per 90 days
  • Maximum of a 3 month supply at a time
Lancet Device
  • Maximum 1 device every 6 months
If additional testing supplies are required based on the Member’s medical condition, prescribers must a submit a prior authorization with medical documentation.

For more information on our Disease Therapy Management Program, Click Here.