Medicare AdvantageDecember 31, 2019
Medicare preferred continuous glucose monitors
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
On January 1, 2020, Empire BlueCross BlueShield (Empire) will implement a preferred edit on Medicare-eligible continuous glucose monitors (CGMs). Currently, there are two CGM systems covered by CMS under the Medicare Advantage Part D (MAPD) benefit; these are Dexcom and Freestyle Libre. The preferred CGM for Medicare Advantage Part D individual members covered by Empire will be Freestyle Libre. This edit will only affect members who are newly receiving a CGM system. Members will need to obtain their CGM system from a retail or mail order pharmacy – not a durable medical equipment (DME) facility. For Dexcom coverage requests, call 1-833-293-0661.
PUBLICATIONS: January 2020 Empire Provider News
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