Diabetes Center
Information About Diabetes and Insurance Benefits
Diabetes Self Management Education/Training
Enrollment in the Bay Medical Diabetes Center program entitles the participant to 12 months of programmed diabetes education/consultation. This comprehensive program includes the initial class or consultation which can last from 4 to 8 hours and a programmed one month follow-up class lasting 2 hours. The enrollment also allows reasonable telephone consultation or visit, within the twelve-month period, on an as needed available basis, with either a Certified Diabetes Educator or a Registered Dietitian.
Medication and Supplies
Caring properly for your diabetes is expensive. You may be able to avoid out of pocket expense by finding out what your insurance covers. The following information will help you ask the right questions to get the facts about your health insurance benefits for diabetes care. Each company's insurance plan is different and an insurance company can offer several different plans. You need to become familiar with your insurance plan's diabetes care and education benefits.
Take a minute to review these terms before contacting your insurance company:
- Co-Payment: the amount considered to be your share to pay after the insurance company has paid
- Deductible: the amount you must pay before your company pays anything
- Durable Medical Equipment: equipment, hardware, or medical devices such as blood glucose meters, special shoes, insulin syringes, lancers, strips and control solutions
- Lifetime benefit: a maximum amount payable for a service for the life of the insured
- Pre-authorization: to obtain insurance company approval before the care is given
- Benefits: the amount the insurance company will reimburse for services provided
- Claim: a request to pay for services
- CDE: Certified Diabetes Educator who is a health care provider and has met the national standards and criteria for diabetes education
Getting The Answers You Need
Now, it is up to you to call your insurance company to find out what your health care benefits for diabetes care and education are. Keep this information handy to discuss treatment, care, and payment options with your diabetes care team.
Have the following ready before you call:
- Primary Insurance: Company name, company phone number, policy number, policyholder's name.
- Secondary Insurance: Name of any other company providing medical insurance coverage, company phone number, policy number, policyholder's name
Information to ask for:
- Name of the person I talked to
- Date
- What is my deductible?
- What diabetes supplies are covered?
- Meter(which ones?)
- Monitoring Strips
- Lancets
- Syringes
- Does my insurance require a prescription for supplies?
- If yes, which ones?
- Are medications paid for?
- Insulin/Insulin Pens(which ones?)
- Pills
- Is there a co-pay and how much?
- Are quantities of covered supplies limited?
- If yes, which ones?
- What is the limit?