Hearing that your blood sugar level is high and that you need to make lifestyle changes to control it can be overwhelming. Without proper care, diabetes can lead to kidney failure, eye problems, nerve damage, heart disease, high blood pressure, strokes, and more.
Eating healthy foods, incorporating physical activity, and maintaining a healthy weight can help bring your blood sugar back to normal levels. These changes could help prevent your condition from progressing.
The good news is your health plan has support to help you. Ask about:
You and your doctor will determine the best schedule for your care. Expect to see your doctor at least 3 or 4 times a year for A1C tests, which show the average blood sugar level over the past few months. This will help your doctor determine if your treatment plan is working or needs to be changed. Your doctor might also test your blood pressure or cholesterol as these can be related to diabetes. These visits are covered in your plan, but are subject to copay and deductible.
Sign in and use Find a Doctor to make sure your doctor and any labs used are in network for your specific plan. You can also look under My Premera Plan to see your plan details.
You might need to take medicine or test your blood sugar. For that, you'll need testing supplies and insulin shots or a pump. Some supplies are covered under your prescription drug benefit. Others fall under medical equipment.
Refer to your plan's benefit booklet for details on what supplies are covered, excluded, and your cost shares. It varies by plan, but a general rule is, if it's disposable, it's covered under your prescription benefit. This can include needles, syringes, test strips, lancets, and glucometer solutions.
To help control costs, we regularly review medications and supplies to make sure they meet our high standards for safety, cost, and best medical practices. With that in mind, we've made LifeScan our preferred manufacturer for diabetes test strips. Please make sure your doctor writes you a prescription for LifeScan test strips. Other test strips won't be covered except for certain clinical reasons.
To search for covered drugs, you'll need the Rx Plan name from your ID card. Then use the drug search tool to search by name.
Medical equipment typically includes insulin pumps and accessories, glucometers, injection aids, and orthotics and orthopedic shoes. These are covered under your durable medical equipment benefit.
Some care and supplies require preapproval to be eligible for coverage. Your doctor can help request this for you.
If you've been diagnosed with diabetes, you need to make sure you have a health care team. This could include:
The captain of your team, is the main source of care. Some people with Type 1 or advanced Type 2 diabetes prefer to see an endocrinologist in addition to or as their primary care provider. If you have both, make sure they're in regular communication so no tests are missed.
If you have gestational diabetes, your obstetrician-gynecologist might act as your primary care provider. If not, make sure your primary care and OBGYN are in communication.
People with diabetes must take greater care to prevent gum disease. Make sure you tell your dentist and keep your regular dental visits.
Registered nurse with special training and a background in caring for and teaching people with diabetes, nurse educators often help you learn the day-to-day aspects of diabetes self-care. Most plans cover health education for people with diabetes at no out-of-pocket cost to the customer.
A registered dietitian (RD) is trained in the field of nutrition. Because food is a key part of your treatment, a dietitian is very important. Your dietitian helps you figure out your food needs based on your weight, lifestyle, medication, and other health goals, such as lowering blood fat levels or blood pressure. Most plans cover nutritional therapy for people with diabetes at no out-of-pocket cost to the customer.
Diabetes can affect the blood vessels in your eyes. We recommend you see your eye doctor at least once a year for a dilated eye exam. This is not considered a routine eye exam; therefore it's covered under your medical plan, not vision.
A podiatrist is trained to treat feet and legs. The American Diabetes Association recommends annual foot exams. We cover these exams as your doctor recommends.
Don't underestimate the emotional toll a diabetes diagnosis can have on you. Your health plan offers coverage for counseling and mental health issues.
Licensed healthcare professionals at Premera who can help you identify barriers to good health and understand your condition. Sign into your online account for contact information.
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Benefits under your health plan may differ, so sign in and refer to your benefit booklet for information on what your specific health plan covers.
Your health plan covers preventive care services as required by state and federal law. For more information, please review the "A" and "B" rated services on the United States Preventive Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on healthcare.gov.
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