24-256 Support Diabetic D-SNP Patients and Help Avoid Incorrect Billing

Date: 03/20/24

Select diabetic supplies must be prescribed in order to be covered by the Plan and Medi-Cal Rx.

Please be aware that diabetic supplies, including meters, test strips and lancets, are a covered benefit for our Dual Special Needs Plan (D-SNP) members. We have been made aware Medi-Cal Rx, who picks up the 20% co-insurance, has restrictions on the brands they will cover when the coordination of benefits (COB) is processed.

As of this update, the below brands are covered by Wellcare By Health Net (the Plan) D-SNP and Medi-Cal Rx:

Meters
NDC	Brand
65702073110	Accu-Chek® Guide Me glucose monitor
99073070805	Freestyle® lite meter
53885004401	One Touch Verio® flex meter
57599881401	Precision Xtra® monitor
56151147002	True Metrix® blood glucose monitor

 

Test strips
NDC	Brand
65702071110	Accu-Chek® guide test strip
99073070822	FreeStyle® lite test strip
53885027025	One Touch® Verio test strip
57599972804	Precision Xtra® test strips
56151146304	True Metrix® glucose test strip

 

Lancet devices
NDC	Brand
65702040010	Accu-Chek® SoftClix lancet kit
65702048110	Accu-Chek® FastClix lancing device
98939000258	Fora® lancing device
8484990355	Prodigy® lancing device

 

Lancets
NDC	Brand
50924097110	Accu-Chek® SoftClix lancets
99073013001	FreeStyle® 28g lancets
99073013001	FreeStyle® 28g lancets
56151014401	TRUEplus® ultra thin 30g lancet

D-SNP members should have no copayment for brands covered by BOTH the Plan D-SNP and Medi-Cal Rx.

The pharmacy must bill Express Scripts (ESI) and Medi-Cal Rx for the secondary claim payment.

Additional information

For additional information and resources about D-SNP, please refer to the D-SNP Resources for Providers.

If you have questions regarding the information contained in this update, contact the Plan Provider Services Center by email, by telephone or through the Plan provider portal.

 

This information applies to Physicians, Participating Physician Groups (PPGs), and Hospitals.