Change in coverage for continuous glucose monitors for some fully insured groups
We will notify affected members via mail. Members who need to transfer CGMs from their medical benefit to their pharmacy benefit will need a new prescription from their provider.
Note that some Anthem groups will retain their medical DME coverage for CGMs and these members will have the option of using either the medical or pharmacy benefit. Generally, members receive their CGMs faster when obtained using their pharmacy benefit, so we encourage the use of the pharmacy benefit.
If you have questions, please contact Provider Services.
November 2021 Anthem Provider News - Ohio