Covered Diabetic Supplies for Colorado Option Plans
UnitedHealthcare Colorado Option Individual & Family plans cover the below listed diabetic supplies at no additional cost to you when provided by an in-network provider. Even if your plan has a deductible and you haven’t met it yet, your cost share is still $0 for these diabetic supplies.
Covered Diabetic Supplies
Insulin PumpsCovered by both Pharmacy and Medical |
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| Pharmacy: your pharmacy benefit covers Omnipod 5, but you must get a prior authorization before your plan covers it. | Medical: your medical benefit covers insulin pumps through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you. |
Syringes & NeedlesCovered by both Pharmacy and Medical |
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| Pharmacy: your pharmacy benefit covers various syringes and needles to administer your insulin. | Medical: your medical benefit covers various syringes and needles to administer your insulin through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you. |
Blood Glucose Monitors and Test StripsCovered by both Pharmacy and Medical |
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Pharmacy: Glucose monitors
Test strips
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Medical: your medical benefit covers blood glucose monitors and test strips through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you.
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Continuous Glucose Monitors (CGM)Covered by both Pharmacy and Medical |
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Pharmacy: your pharmacy benefit covers the following CGMs, but you must get a prior authorization before your plan covers it:
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Medical: your medical benefit covers continuous glucose monitors (CGM) through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available to you. |
Other Covered Diabetic SuppliesCovered by both Pharmacy and Medical |
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Pharmacy: your pharmacy benefit covers items such as:
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Medical: your medical benefit covers other diabetic supplies through our Durable Medical Equipment (DME) benefit when clinical guidelines are met and when obtained from DME providers designated by us. Contact a DME provider listed below for specific brands available for items such as:
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Where can I learn more about Prescription Drug Benefits?
- To learn more about a product on this list, check your Prescription Drug List for tier information, coverage rules, and any limits, such as quantity limits.
- To find a network pharmacy, check the Provider Directory. Have your network pharmacy submit a claim to Optum Rx (our pharmacy service provider) to process the claim under your pharmacy benefit.
Where can I learn more about Durable Medical Equipment (DME) products?
To learn more about specific Durable Medical Equipment (DME) products covered through your medical benefit, please reach out to one of our DME Providers listed below to obtain information about products available to you:
DME Providers |
Phone Number |
Website |
|---|---|---|
AdaptHealth LLC |
844-727-6667 | https://adapthealth.com/ |
Advanced Diabetes Supply |
866-422-4866 | https://northcoastmed.com |
Byram Healthcare |
https://www.byramhealthcare.com/ | |
Edgepark |
http://www.edgepark.com/ | |
MiniMed/Medtronic |
http://www.medtronicdiabetes.com/home | |
Insulet Corporation |
http://www.myomnipod.com/ | |
Synapse Health |
https://synapsehealth.com | |
Tandem Diabetes Care |
http://www.tandemdiabetes.com | |
US MED |
https://www.usmed.com/ |
Prior Authorization
What if my diabetic supplies require prior authorization?
If your plan requires prior authorization for a diabetic supply, your healthcare provider (doctor, nurse practitioner, etc.) will give us information about your diagnosis, treatment history and other relevant information to request prior authorization. If the prior authorization request is approved, you will pay a $0 cost share, not subject to a deductible.
To request a prior authorization:
- Health care providers:
- Pharmacy Benefit: Please contact OptumRx by calling 1‐800‐711‐4555 or submit an online prior authorization request at: professional.optumrx.com.
- Medical Benefit: Please submit an online prior authorization request through the provider portal.