Both HMO Illinois and BlueAdvantageSM HMO include coverage for diabetic conditions and benefits for prescription drugs, durable medical equipment (DME) and over-the-counter diabetic supplies.
Coverage for diabetic drugs is as follows:
- Members can purchase oral medication, insulin and insulin syringes with a doctor's prescription at any contracting retail pharmacy.
- The cost is the same as the member's prescription drug copayment.
- Members can order a 90-day supply of diabetic medication via the BCBSIL home delivery pharmacy.
Durable Medical Equipment (DME)
Glucose monitors are considered DME and require a doctor's order or prescription and a referral to a contracting provider. Most DME providers will bill the HMO directly; some may require purchase of the equipment.
Over-the-Counter Diabetic Supplies
Both BCBSIL HMO plans provide coverage for diabetic supplies including blood glucose testing strips, urine reagents, injectable glucagon, lancets and oral glucose tablets.
Coverage for diabetic supplies is as follows:
- With a prescription card - Members can obtain diabetic supplies at the drug store and your only cost is your prescription drug copayment. There are no claim forms to submit.
- Through home delivery - The home delivery drug program allows members to get up to a 90-day supply of diabetic supplies with the convenience of home delivery.
- At the drug store - Members can purchase these items directly and submit a claim to the BCBSIL HMO.
- Lancets are covered at no additional cost with a prescription.