Your Value Based Benefits Learn about no-cost services and medications available to members who are managing diabetes. Value based benefits cover certain medical services and drugs at 100% (no deductible or coinsurance) for members who are diagnosed with a particular medical condition. When a claim form or prescription is submitted, the service or medication/supply is automatically processed with no deductible, coinsurance or copay. What Are Value Based Benefits? Have Questions About Value Based Benefits? Contact HealthSCOPE Benefits Talk to your pharmacist about how you may be able to switch to one or more of these covered drugs. W E C A R E A B O U T Y O U R D I A B E TI C H E A L T H
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YourValue BasedBenefitsLearn about no-cost services and medications available to members who are managing diabetes.
Value based benefits cover certain medical
services and drugs at 100% (no deductible or
coinsurance) for members who are diagnosed
with a particular medical condition. When a
claim form or prescription is submitted, the service
or medication/supply is automatically processed
with no deductible, coinsurance or copay.
What AreValue Based Benefits?
Have Questions AboutValue Based Benefits?
Contact HealthSCOPE Benefits
Talk to your pharmacist about how you may be
able to switch to one or more of these covered drugs. WE C
ARE
ABOU
T YOUR DIABETIC HEALTH
MedicalServices • Up to 4 physician office visits per year for diabetic–related care• Hemoglobin A1C test (4 per yr)• Lipid profile test (2 per year)• Microalbumin test (1 per year)• Annual flu shot• Pneumonia vaccine (once then every 5 years if ordered by a physician, up to age 65)• Diabetes education (up to 10 sessions in one year, up to 4 hours in each of
2 subsequent years)• Podiatric visits as referred by MD/DO/NP, up to once every 6 months• Annual dilated eye exam
glyburide–metformin• Insulin (vials only) – LANTUS, LEVEMIR, HUMALOG, NOVOLOG*• Lipid control agents – atorvastatin, lovastatin, pravastatin, simvastatin*• Blood pressure and cholesterol control agents – see coronary artery disease list at left*• Diabetic test strips – Accu-Check Aviva, Accu-Check Aviva Plus, Accu-Check Compact,
One Touch Ultra Test Strips*• Blood/Glucose meters – Accu-Check Aviva, Accu-Check Aviva Plus, Accu-Check Compact,
One Touch Ultra 2, One Touch Ultra Mini• Lancets, syringes and needles
* Covered drugs and supplies specifically outlined
Only drugs listed will be covered at 100%. Those listed in all capital letters are brand medications. Those listed in lower case letters are generic medications, and their brand equivalent will not be covered at 100%.
Our value based program is designed with your improved health in mind. By appropriately testing, taking medications as prescribed, and seeing your doctor for medical care you can prevent many of the complications associated with diabetes. Take good care of yourself and enjoy this benefit.
