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Adult Glucose Monitoring Equipment, Insulin Pumps, and Supplies: FAQ's

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Adult Glucose Monitoring Equipment, Insulin Pumps, and Supplies: FAQ's HEALTH EDUCATION HEALTH EDUCATION Adult Glucose Monitoring Equipment, Insulin Pumps, and Supplies: FAQ's Are glucose meters covered under my Health Plan benefit? Yes, home blood glucose meters and supplies are covered by your Health Plan benefit when your doctor prescribes them. The supplies Our goal is to find the include test strips, lancets, and lancing devices. The meter and best way to help you supplies are covered under a special benefit for members, called the manage your diabetes. Durable Medical Equipment (DME) benefit. These diabetes supplies You will work with your and all refills are available at any local Kaiser Permanente pharmacy. diabetes care team to Your health care provider may prescribe a home glucose meter and discuss your diabetes and supplies for you when: the equipment and • You have a diagnosis of diabetes; and supplies that may be • Blood sugar monitoring is medically necessary for you to control appropriate for you. your diabetes. What types of glucose meters are available at Kaiser Permanente? The LifeScan OneTouch® VerioTM IQ is the glucose meter that Kaiser Permanente health care providers prescribe most often. Some patients will have the OneTouch® Ultra® 2 meter instead, which is also an approved meter. Physicians may prescribe different meters for Kaiser Permanente members who are blind, have severe vision problems, or who have challenges using their hands and can’t use the OneTouch® VerioTM IQ meter. How many glucose meters are covered under my DME benefit? The DME benefit covers one working glucose meter at a time. You must have a valid prescription for a meter from your health care provider. What if I do not qualify for a DME covered glucose meter, but would like to purchase one? Kaiser Permanente pharmacies do not sell glucose meters as over-the-counter products. If you wish to purchase a meter, please check with your local Kaiser Permanente pharmacy. You will be referred to a non-Kaiser Permanente pharmacy. What if my glucose meter is not working? First, call the meter company’s Customer Service number to get help. You can find this number on the back of the meter. The Customer Service department will work with you over the phone to try to fix the problem. They will tell you if the meter needs to be replaced. E-Handout #1066-E (Revised 5/16) RL 8.6 Page 1 of 3 © 2009, The Permanente Medical Group, Inc. All rights reserved. Regional Health Education. HEALTH EDUCATION Glucose Meter Name Phone number to Call OneTouch® VerioTM IQ 1-888 567-3003 (English) or 1-888 567-3010 (Español) OneTouch® Ultra®2 1-800 227-8862 (English) or 1-800 381-7226 (Español) If the glucose meter stops working at any time, your local Kaiser Permanente pharmacy will replace it at no charge as long as there was no apparent abuse or neglect of the broken one, and it was still under warranty. The warranty applies only to the person who originally purchased the meter. The warranty does not cover the battery that comes with the OneTouch® Ultra® 2 meter. If your glucose meter is broken and the warranty period is over, your physician can issue a new prescription for a glucose meter. As long as there was no abuse or neglect of the old meter, the new one would be covered under the DME benefit. Are insulin pumps covered under my Health Plan? Insulin pumps may be approved for adult members if all of the conditions listed below are met and noted in the patient’s medical record. The insulin pump candidate must: Have a diagnosis of diabetes which always needs to be treated with insulin. Check his or her blood sugar 4-8 times a day. Show advanced carbohydrate counting skills. Use 3-4 insulin injections a day. Have worked with a Kaiser Permanente diabetes care team for at least six months, but did not get to blood sugar targets or treatment goals. Have an order from a Kaiser Permanente endocrinologist for an insulin pump. In addition, patients should be aware that setting up and using a pump correctly takes some time and assistance from a diabetes care team. Can I choose an insulin pump from any manufacturer? Kaiser Permanente’s DME office selects the suppliers of these devices. The current insulin pump suppliers are Animas, Tandem, and Medtronic Minimed. Insulin pumps from these companies are covered under your Health Plan benefits. How often can I get a new insulin pump? If you meet the criteria for an insulin pump (listed above), a pump will be replaced if it is no longer working properly. Your Health Plan benefit does not cover the cost of upgrading your insulin pump to a pump with newer technology. The insulin pump has a four-year warranty. The Health Plan replaces the insulin pump when it is no longer working properly, not when the warranty expires. E-Handout #1066-E (Revised 5/16) RL 8.6 Page 2 of 3 © 2009, The Permanente Medical Group, Inc. All rights reserved. Regional Health Education. HEALTH EDUCATION How do I order supplies for my insulin pump? Once a Kaiser Permanente endocrinologist has ordered you an insulin pump and the necessary supplies, you can refill your insulin pump supplies by calling the Kaiser Permanente DME refill number at 1-877-317-6230. Are continuous glucose monitors covered under my Health Plan benefit? Continuous glucose monitors (CGM) may be approved for adult members if all of the following conditions are met and noted in the patient’s medical record. The CGM candidate must: Have a diagnosis of diabetes. Check their blood sugar at least 6 times a day. Use at least 4 insulin injections a day or use an insulin pump. Have worked with a Kaiser Permanente endocrinologist or diabetes specialist for at least 6 months. Continue to have frequent and/or severe low blood sugars of less than 50 mg/dL in spite of efforts to control blood sugar with the help of a Kaiser Permanente endocrinologist, diabetes specialist or a diabetes care team. If the conditions above are met, a Kaiser Permanente endocrinologist may submit an order for the continuous glucose monitor. * * * * * Other resources . Visit kp.org/mydoctor/diabetes for day-to-day tips and tricks on how to live well with diabetes. Contact your Kaiser Permanente Health Education Center or Department for health information, programs, and other resources. This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. E-Handout #1066-E (Revised 5/16) RL 8.6 Page 3 of 3 © 2009, The Permanente Medical Group, Inc. All rights reserved. Regional Health Education. .
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