We're expanding access to diabetes monitoring products for commercial members, starting Jan. 1, 2021

Starting Jan. 1, 2021, diabetes monitoring products, such as glucometers and test strips, lancets, continuous glucose monitors and insulin delivery devices, will be added to the pharmacy benefit for Blue Cross commercial and Blue Care Network commercial members.

Members will be able to obtain diabetes monitoring products or supplies through participating pharmacies or through durable medical equipment providers, as outlined below.

Through participating pharmacies

Select glucometers and continuous glucose monitors will be available through members' pharmacy benefit with no cost share.

Other diabetes supplies will be covered according to the drug list for the member's plan; the appropriate pharmacy cost share or copayment will apply.

Glucometers and continuous glucose monitoring products that are available with no cost share include:

  • OneTouch Verio Reflect®
  • OneTouch Verio Flex®
  • OneTouch Ultra® 2
  • Contour®
  • Contour Next
  • Contour Next One
  • Contour Next EZ
  • Dexcom G5™ receivers and transmitters
  • Dexcom G6™ receivers and transmitters

Through durable medical equipment providers

Members can also obtain diabetes monitoring products through a DME provider. The steps to locate DME providers vary depending on a member's plan:

  • Blue Cross commercial fully insured groups: These members must obtain their diabetes monitoring products through a Northwood, Inc. network provider starting Jan. 1. To find a Northwood network provider, members can do one of the following:
    • Log in to their Blue Cross member account (through bcbsm.com or our mobile app) and click on Find a Doctor.
    • Go to bcbsm.com/dmesupplies and click on Find a Doctor.

    A Northwood icon appears next to each Northwood network provider.

  • Blue Cross commercial self-funded groups: To find a network provider, members can log in to their secure member account (through bcbsm.com or our mobile app) and click on Find a Doctor.
  • BCN commercial members: To find a J&B Medical Supply network provider, members can do one of the following:
    • Log in to their secure member account (through bcbsm.com or our mobile app) and click on Doctors & Hospitals. They can then click on the durable medical equipment link.
    • Call J&B Medical Supply at 1-888-896-6233.

What this change means

This change effects members as follows:

  • Blue Cross commercial fully insured groups: For these groups and members, we're moving to one provider, Northwood, beginning Jan. 1, 2021.

    • Starting Jan. 1, if members use a provider in the Northwood network, their medical copayment, cost share, coinsurance or deductible won't change.

    However, if members use a provider outside the Northwood network on or after Jan. 1, they may pay a higher copay, cost share, coinsurance or deductible. Members can obtain diabetes supplies and prescriptions from a participating network pharmacy or from a provider through the Northwood network.

  • Blue Cross commercial self-funded groups: There's no change to how members obtain durable medical equipment. Members can continue to get diabetes supplies from the durable medical equipment provider they're using now under the pharmacy benefit.
  • BCN commercial members: J&B Medical Supply is the DME provider for BCN commercial members; there won't be a negative effect on members who currently receive diabetes monitoring supplies under the medical benefit. This change simply expands access by allowing members to get diabetes supplies and prescriptions from participating network pharmacies, in addition to the durable medical equipment providers they’re using now.

Posted: December 2020
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network