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Diabetic Testing Supplies Preferred Products for Health Partners Medicare Members Preferred diabetic testing items are available to all Health Partners Medicare members for 0% coinsurance*. A prescription for diabetic testing supplies may be required from your provider. Please show your Health Partners Medicare card when filling a prescription at the pharmacy. *If you have both Medicaid and Health Partners Medicare, please show both of your cards at the pharmacy to ensure the 0% coinsurance. Ascensia Diabetes Care CONTOUR Meter CONTOUR Test Strips CONTOUR LINK Meter CONTOUR NEXT Meter CONTOUR NEXT EZ Meter CONTOUR NEXT LINK Meter CONTOUR NEXT ONE Meter CONTOUR NEXT Test Strips Abbott Diabetes FreeStyle InsuLinx FreeStyle InsuLinx Test Strips FreeStyle Libre 14-day Reader FreeStyle Libre 14-day Sensor FreeStyle Libre 2 Reader FreeStyle Libre 2 Sensor FreeStyle Lite Meter FreeStyle Freedom Lite Meter FreeStyle Lite Test Strips FreeStyle Test Strips Precision Xtra Precision Xtra Test Strips FreeStyle Precision Neo FreeStyle Precision Neo Test Strips

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Page 1: Diabetic Supplies List...Diabetic Testing Supplies Preferred Products for Health Partners Medicare Members Preferred diabetic testing items are available to all Health Partners Medicare

Diabetic Testing Supplies Preferred Products for Health Partners Medicare Members

Preferred diabetic testing items are available to all Health Partners Medicare members for 0% coinsurance*. A prescription for diabetic testing supplies may be required from your provider. Please show your Health Partners Medicare card when fi lling a prescription at the pharmacy.

*If you have both Medicaid and Health Partners Medicare, please show both of your cards at the pharmacy to ensure the 0% coinsurance.

Ascensia Diabetes CareCONTOUR MeterCONTOUR Test StripsCONTOUR LINK MeterCONTOUR NEXT Meter

CONTOUR NEXT EZ MeterCONTOUR NEXT LINK MeterCONTOUR NEXT ONE MeterCONTOUR NEXT Test Strips

Abbott Diabetes FreeStyle InsuLinxFreeStyle InsuLinx Test StripsFreeStyle Libre 14-day Reader FreeStyle Libre 14-day Sensor FreeStyle Libre 2 ReaderFreeStyle Libre 2 SensorFreeStyle Lite Meter

FreeStyle Freedom Lite MeterFreeStyle Lite Test StripsFreeStyle Test StripsPrecision XtraPrecision Xtra Test StripsFreeStyle Precision NeoFreeStyle Precision Neo Test Strips

Page 2: Diabetic Supplies List...Diabetic Testing Supplies Preferred Products for Health Partners Medicare Members Preferred diabetic testing items are available to all Health Partners Medicare

More Information

• Prior authorization is required for diabetic monitoring supplies from non-preferred manufacturers. If supplies from non-preferred manufacturers are approved by Health Partners Medicare, you will pay 20% coinsurance.

• Diabetic test strips have quantity limits. You can receive 150 test strips per 30 days (or up to 450 test strips per 90 days). Prior authorization is required if you need a higher quantity per month.

• Visit HPPMedicare.com/prescription-drugs/formularies to review the diabetic products we cover.

If you have questions, call Member Relations at 1-866-901-8000 (TTY 1-877-454-8477). We are available 24 hours a day, seven days a week.

Health Partners Medicare is an HMO plan with Medicare and Pennsylvania State Medicaid program contracts. Enrollment in Health Partners Medicare depends on contract renewal.

H9207_HPM-540RX-2375_C


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