HCD Diabetes Payer List for IP and CGM · 2020. 9. 4. · HCD Diabetes Payer List for IP and CGM...

HCD Diabetes Payer List for IP and CGM

Virginia

Plan Name Plan TypeTandem Insulin

Pump & Supplies Dexcom Libre OmniPod

Anthem BCBS Federal Employee Program Commercial No Yes Yes No

Anthem BCBS VA Medicaid Managed Medicaid Yes Yes Yes No

Anthem BCBS VA Commercial Commercial Yes Yes Yes Yes

Aetna Better Health - VA Managed Medicaid Yes Yes Yes Yes

Aetna Better Health - VA DSNP No Yes Yes No

Anthem Healthkeepers Managed Medicaid Yes Yes Yes No

Anthem VA D-SNP DSNP No Yes Yes No

Medicaid Medicaid Yes Yes Yes No

Medicare Medicare No Yes Yes No

Optima*Medicaid, Medicare Advantage,

DSNP & CommercialYes Yes Yes No

Piedmont Community Health Plan Commercial Yes Yes Yes Yes

Tricare (East) Military No Yes Yes No

Virginia Premier Managed Medicaid No Yes Yes No

Virginia Premier Medicare Advantage No Yes Yes No

*At this time, HCD is only able to provide these supplies via Single Case Agreements.

Maryland



Aetna Better Health of Maryland Managed Medicaid No Yes Yes No

Amerigroup MD Managed Medicaid Yes Yes Yes Yes

Johns Hopkins Priority Partners MCO Medicaid No Yes Yes No

Johns Hopkins Advantage MD Medicare Advantage No Yes Yes No

Maryland Physicians Care Managed Medicaid No Yes Yes No


Medstar Family Choice MD Managed Medicaid Yes Yes Yes Yes

Medstar Select Commercial Yes Yes No Yes

University of Maryland Health Advantage Medicare Advantage No Yes Yes Yes

University of Maryland Health Partners Managed Medicaid Yes Yes Yes Yes


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Urology • Wound Care • Ostomy • Incontinence • Diabetes • Breast Pumps • Nutritionals

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HCD090420

Updated 9/4/20

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Washington DC



AmeriHealth Caritas - DC Managed Medicaid Yes Yes Yes Yes

CareFirst CHPDC Managed Medicaid Yes Yes Yes Yes

MedStar Select Commercial Yes Yes No Yes

Medicaid Medicaid No No Yes No



Pennsylvania



AmeriHealth Commercial- PA, NJ, DE Commercial Yes Yes Yes Yes

AmeriHealth PA Medicare Advantage Medicare Advantage Yes Yes Yes No

Capital Blue Cross - Senior Journey - PA MA Medicare Advantage Yes Yes Yes No

Capital Blue Cross PA Commercial Commercial Yes Yes Yes Yes

Gateway Health Plan Medicaid Managed Medicaid Yes Yes Yes Yes

Gateway Health Plan Medicare Assured Medicare Advantage No Yes Yes Yes

Geisinger Health Plan Commercial Yes Yes Yes Yes

Geisinger Health Plan Family Commercial Yes Yes Yes Yes

Geisinger Health Plan Geisinger Health Plan Kids-CHIP Yes Yes Yes Yes

Geisinger Health Plan (Geisinger Gold) Medicare Advantage No Yes Yes No

Highmark PA Commercial Commercial Yes Yes Yes Yes

Independence BC PA Keystone Commercial Commercial Yes Yes Yes Yes

Independence BC PA Keystone Med. Adv. Medicare Advantage Yes Yes Yes No

Independence BC PA Personal Choice Commercial

Commercial Yes Yes Yes Yes

Independence BC PA Personal Choice Med. Adv.

Medicare Advantage Yes Yes Yes No

Medicaid Medicaid No Yes Yes No


UPMC Community HealthChoices Commercial Yes Yes Yes No


HCD090420

HCD Diabetes Payer List for IP and CGMUpdated 9/4/20

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Delaware



AmeriHealth Caritas DE Managed Medicaid Yes Yes Yes Yes



Traditional Delaware Medicaid Medicaid No Yes Yes Yes


West Virginia



The Health Plan Medicare Advantage No Yes Yes No



Kentucky




Aetna Better Health of Kentucky Managed Medicaid Yes Yes Yes Yes

Anthem BCBS KY Commercial Yes Yes Yes Yes

Anthem BCBS KY Medicaid Managed Medicaid Yes Yes Yes Yes

CareSource Just4Me KY Commercial Yes Yes Yes Yes

Humana - KY Managed Medicaid Yes Yes Yes Yes


Passport Advantage KY Medicare Advantage Yes Yes Yes No

Passport Health Plan of Kentucky Managed Medicaid Yes Yes Yes Yes

WellCare KY Managed Medicaid Yes Yes Yes Yes

Passport Advantage KY Medicare Advantage Yes Yes Yes No


HCD090420


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Tennessee



BCBS Tennessee - BlueCare Managed Medicaid No Yes Yes Yes

BCBS Tennessee - TennCare Select Managed Medicaid No Yes Yes Yes

BCBS-TN Commercial No Yes Yes Yes



Georgia



Anthem BCBS Federal Employee Program

Commercial No Yes Yes No

Anthem BCBS - Commercial Commercial Yes Yes Yes Yes

CareSource GA Families Managed Medicaid Yes Yes Yes Yes

CareSource Just4ME GA Exchange Yes Yes Yes Yes



Texas



BCBS-TX BlueChoice PPO ONLY No No Yes No

CHRISTUS Health Plan Managed Medicaid Yes Yes Yes Yes*


Molina Healthcare of Texas, Inc. Managed Medicaid Yes Yes Yes No

Molina Healthcare of Texas, Inc. Medicare Advantage No Yes Yes No

Tricare (East)** Military No Yes Yes No

*OmniPod is only covered for ages 20 and under ** (excluding El Paso area)

HCD090420


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HCD090420

Ohio




Aetna Better Health of OH -MyCare Dual Options MMP

MLTSS Yes Yes Yes No

Aetna Better Health of OH -MyCare Medicaid

Managed Medicaid Yes Yes Yes No

Ambetter OH Buckeye Health Plan Commercial Yes Yes Yes Yes

CareSource Just4Me Ohio Commercial Yes Yes Yes No

CareSource MMP Medicaid Only Managed Medicaid Yes Yes Yes No

CareSource OH MCO Managed Medicaid Yes Yes Yes No


Paramount Advantage MCO Medicaid Yes Yes Yes Yes

The Health Plan Medicare Advantage No Yes Yes No


Missouri




Anthem BCBS Missouri - Commercial Commercial Yes Yes Yes Yes


Tricare (East)* Military No Yes Yes No

*(St. Louis area ONLY)

Michigan



McLaren Health Plan Managed Medicaid No Yes Yes No




Updated 9/4/20

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HCD090420

Indiana




Anthem BCBS IN - Healthy Indiana Plan Managed Medicaid Yes Yes Yes Yes

Anthem BCBS IN - Hoosier Care Connect Managed Medicaid Yes Yes Yes Yes

Anthem BCBS IN - Hoosier HealthWise Managed Medicaid Yes Yes Yes Yes

Anthem BCBS of Indiana Commercial Commercial No No Yes No

CareSource (IN) Healthy Indiana Plan Managed Medicaid No Yes Yes Yes

CareSource (IN) Hoosier Healthwise Managed Medicaid No Yes Yes Yes

CareSource Just4Me Indiana Exchange Yes Yes Yes Yes



New Jersey






Wyoming



Traditional Wyoming Medicaid Medicaid Yes Yes Yes No

North Carolina



BCBS -North Carolina Commercial Yes Yes Yes Yes

Medicaid Medicaid Yes No No Yes




Updated 9/4/20

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HCD090420

South Carolina



Molina Medicare Options Medicare Advantage No Yes Yes No

Wellcare Medicare Advantage No No Yes No

Wellcare Managed Medicaid No No Yes No



Idaho





Molina ID Medicare Advantage Medicare Advantage No Yes Yes No

Molina ID MMP Managed Medicaid No Yes Yes No

New Mexico




Medicaid Medicaid Yes Yes Yes Yes

Mississippi



Ambetter MS Magnolia Health Managed Medicaid Yes Yes Yes Yes


Traditional Mississippi Medicaid Medicaid Yes Yes Yes Yes



Updated 9/4/20

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HCD090420


Updated 9/4/20Minnesota



HealthPartners MN Commercial Yes Yes Yes Yes



Illinois



Health Alliance (Illinois) Medicare Advantage No Yes Yes No



Iowa



Medicaid Medicaid No Yes Yes No


Wellmark of Iowa Commercial No Yes Yes No


*Rock Island area

Wisconsin




New Hampshire




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HCD090420


Updated 9/4/20Maine




Connecticut




Multiple States

Plan Name Plan Type Tandem Insulin Pump & Supplies Dexcom Libre OmniPod

Medicare* Medicare No Yes Yes No

Tricare (East)** Military No Yes Yes No

*Medicare Coverage Area: HCD can provide Dexcom and Libre to members in all states except for Hawaii.

**Tricare Coverage Area: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area ONLY), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin.

HCD Diabetes Payer List for IP and CGM · 2020. 9. 4. · HCD Diabetes Payer List for IP and CGM...

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