Benefits Plans - Prescription Drug Plan: Drug Plan Updates and New Drug Releases -
Diabetic Insulin and Supplies Clarification
May 3, 2004
Diabetic Injectable Insulin, Needles and Syringes
Diabetic injectable insulin, needles and syringes are available to all participants in the University of Michigan prescription drug plan at a zero ($0) co-pay when the AdvancePCS prescription drug ID card is used at a network retail pharmacy, or from the AdvanceRx.com mail order pharmacy.
Coverage of diabetic supplies (injection devices, alcohol swabs, testing strips, lancets, and blood glucose testing monitors) is determined by your medical insurance plan participation as described below.
Comprehensive Major Medical Participants
Diabetic supplies are covered for Comprehensive Major Medical (CMM) participants only with a zero ($0) co-pay when the AdvancePCS prescription drug ID card is used at a network retail pharmacy, or from the AdvanceRx.com mail order pharmacy.
Participants in All Other Medical Insurance Plans
For all other participants in the University of Michigan prescription drug plan, diabetic supplies are available at a zero ($0) co-pay only when the medical insurance ID card is used at an authorized Durable Medical Equipment (DME) provider. Contact your medical insurance plan administrator (M-CARE, Care Choices, Health Alliance Plan, or Blue Cross Blue Shield of Michigan) for further instructions on how to obtain diabetic supplies through the medical plan's DME suppliers.
Reimbursement Claims for Diabetic Supplies and Equipment
For diabetic supplies purchased out-of-pocket and then submitted for reimbursement, the refund may be reduced to the price contracted with authorized DME providers. Submit claim forms to your medical plan (only CMM members can use AdvancePCS claim forms for diabetic supplies). Participants in BCBSM/United of Omaha who submit diabetic supplies receipts to United of Omaha will be limited to the standard 80% reimbursement.
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.