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October 25, 2022

Effective Jan. 1, 2023, we’re transitioning coverage for continuous glucose monitors (CGMs) from our medical plans to pharmacy benefits. This shift will allow members to obtain all their diabetes management supplies from one provider, saving them money and providing a more convenient member experience.

This coverage change is applicable to members on Small Group (1-50; 2-50 in Idaho), Individual Metallic, fully insured 51+ and ASO plans. It will also apply to legacy and transitional plans without impacting their existing status. ASO groups with carved-out PBMs will not be impacted; CGMs will continue to be covered through their medical plans. ASOs may also customize their choices to keep the CGM benefit on their medical plans.

Affected members have received communications from Customer Service advising them of the cost savings and convenience of obtaining CGMs through their pharmacy, along with notifications about CGM coverage switching from their medical to pharmacy benefit. Providers and suppliers have also been updated about this benefit change.

Questions? Please contact your account representative.