Managing chronic and serious conditions can be a lot of work, but it’s essential to staying on top of your health. That’s why we offer specialized programs to help our members who have diabetes, congestive heart failure, and kidney disease.

Are you eligible?

Call our dedicated care management team: 1-800-392-0098 (TTY: 711)

8:30 am to 4:30 pm ET, Monday - Friday

If you have type 1 or type 2 diabetes, your plan benefits will cover the cost to buy certain medically necessary diabetic testing supplies. See below to understand how diabetic test strips and monitors are covered under your plan. Also, Medex plans with the Syringes and Needles rider have no cost for needles and syringes. Plus, Medicare Advantage members have access to a highly-trained team of Diabetes Navigators from Team Blue who will use their specific skills and knowledge to help guide and support you.

Coverage for Diabetic Testing Supplies and Insulin and Syringes:

Getting your medically necessary testing supplies at no-cost is easy. Based on your plan type, you may be eligible for a no-cost purchase at the pharmacy, or mailed reimbursement with your receipt. See the chart below for coverage on testing supplies, insulin, and syringes.

Coverage For: You Pay:
  • Insulin and syringes
  • One Touch brand test strips and glucose monitors
  • Lancets and Lancet Devices
  • Your Tier 3 cost-share (after meeting deductible) for insulin and syringes.
  • Nothing for the One Touch®´ blood glucose test strips and blood glucose monitors purchased at participating retail or mail-order pharmacies.
  • Nothing for Lancet Devices and Lancets

 

Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible (if applicable).

One-on-One Help From a Diabetes Expert

The Diabetes Navigator Program is a specialized program designed to provide tailored support and resources to our Medicare Advantage members with diabetes or prediabetes. The Team Blue Navigators are trusted advocates that are on-hand to encourage and support your journey when managing this chronic condition. The goal is to:

  • Motivate you to make critical lifestyle changes through an awareness of barriers such as cost, resources, transportation, and benefit understanding
  • Offer extensive knowledge, awareness, and support

To talk to a Diabetes Navigator, call 1-800-200-4255 (TTY: 711), 8:00 a.m. to 5:00 p.m. ET, Monday through Friday.

Coverage For: You Pay:
  • Needles and syringes1
  • Medicare-approved diabetic testing supplies
  • Insulin for Insulin Pump: covered by Medicare as primary insurance
  • Lancet Devices, Lancets and Glucometers
  • The full cost when buying the needles and syringes, then submit the receipt with the Medex Claim Form.1,2
  • Medicare deductible at point of sale for testing supplies; pharmacy reimburses once plan pays (if applicable).
  • Insulin for pump: Part B deductible and/or coinsurance per benefit structure
  • Medicare Part B (Medical Insurance) covers lancet devices, lancets and glucometers as supplies used with durable medical equipment (DME); Medex covers Part B deductible and/or coinsurance per benefit structure

 

Questions?

Call us at 1-800-258-2226 (TTY: 711)
8:00 a.m. to 6:00 p.m. ET, Monday through Friday.

1. Subject to plans with Syringes and Needles rider
2. You have two (2) years from the date of purchase to submit a claim form for reimbursement.
Please send your receipt and claim form to: BCBSMA P.O. Box 986030 Boston, MA 02298

Coverage For: You Pay:
  • Needles and syringes
  • Medicare-approved diabetic testing supplies
  • Insulin for Insulin Pump: covered by Medicare as primary insurance
  • Insulin (all other forms); refer to your prescription drug benefit or Medicare Part D prescription drug plan
  • Lancet Devices, Lancets and Glucometers
  • Your member copay or cost-share for needles and syringes, then submit the receipt with a Medex Claim Form.1,2
  • Medicare deductible at point of sale for testing supplies; pharmacy reimburses once plan pays (if applicable).
  • Insulin for pump: Part B deductible and/or coinsurance per benefit structure
  • Insulin (all other forms): Your cost-share per pharmacy benefit structure; you are responsible for paying your Part D cost-share
  • Medicare Part B (Medical Insurance) covers lancet devices, lancets and glucometers as supplies used with durable medical equipment (DME); Medex covers Part B deductible and/or coinsurance per benefit structure

 

Questions?

Call us at 1-800-258-2226 (TTY: 711)
8:00 a.m. to 6:00 p.m. ET, Monday through Friday.

1. Subject to plans with Syringes and Needles rider
2. You have two (2) years from the date of purchase to submit a claim form for reimbursement.
Please send your receipt and claim form to: BCBSMA P.O. Box 986030 Boston, MA 02298

We’re working with home health care providers (visiting nurse organizations) to give Medicare Advantage members managing congestive heart failure access to in-home telemonitoring services, at no additional cost. With this program, you’ll have:

  • Fewer visits to the doctor
  • Convenient setup for ongoing in-home health monitoring

To see if you’re eligible, call Team Blue at 1-800-392-0098 (TTY: 711), 8:30 a.m. to 4:30 p.m. ET, Monday through Friday. If you qualify, the health home organization will work directly with your doctor to develop and implement a care plan. Then, they’ll send a nurse to you to set you up for the program.

We want to support our members on their health journeys by making sure they get the help they need, when they need it. That’s why we’ve teamed up with Square Knot Health, an independent company specializing in kidney disease management, to support the care of our members managing chronic kidney disease (CKD).

If you qualify, Square Knot will pair you with a specially trained kidney disease navigator who will:

  • Assess your current kidney disease status and overall health
  • Partner with your nephrologist and primary care provider to support you and develop a plan specific to your needs
  • Be a readily available resource for questions related to your kidney health

For more information on the program, visit squareknot.com. To see if you’re eligible, call Team Blue at 1-800-392-0098 (TTY: 711) and press 1, Monday through Friday, 8:30 a.m. to 4:30 p.m. ET.