State of Ohio members are eligible for free diabetic supplies and medications if they have had a Hemoglobin A1c test within the past 12 months while covered by the State. Specific test values and results are not required, only that the member has had the test.
Enrolling is simple – you must first have an A1c test performed by your provider. Once the claim for the test has been processed by your medical third-party administrator, they will send your information to OptumRx. It can take 30 to 60 days for your medical third-party administrator and OptumRx to reflect your eligibility for this program in their respective systems.
For those members that meet these guidelines, the supplies and durable medical equipment listed below are provided at no cost. There is nothing else you need to do.
Durable Medical Equipment
These items are covered by your medical third-party administrator (Anthem or Medical Mutual of Ohio) when purchased through an in-network provider. Please verify coverage with your third-party administrator prior to obtaining equipment.
- Internal insulin pumps
- External insulin pumps
- Insulin pump supplies, including:
- Insertion devices
- Batteries (Lithium only)
- Infusion sets
- Continuous glucose monitoring equipment
- Sensor insertion devices
- Sensor pads
- Replacement parts
- Other items
- Liquid adhesive and adhesive remover wipes
- Tape, adhesive patches, dressings and film
These items are covered by OptumRx through a retail store/pharmacy, specialty provider or traditional mail-order. Prescriptions are needed to fill requests for these supplies at a $0 copay.
- Syringes and Pens
- Insulin syringes and needles
- Insulin pens and needles
- Meters and Testing Supplies:
- Blood glucose meters
- Test strips, tablets (urine and blood)
- Control solution
- Lancing devices
- Alcohol prep wipes/pads
- Glucagon emergency kits
- Glucose chewable tablets
Members that have not met the clinical guidelines will still have coverage for these items, but with copays, coinsurance and deductibles under the normal provisions of the State of Ohio plan.