Preferred continuous glucose monitors
Preferred CGM edits do not apply to the following plans/plan types:
- Employer Group Waiver Plans (EGWP) Medicare Advantage Part D (MAPD) through Empire
- Employer Group Waiver Plans (EGWP) Medicare Advantage (MA only) through Empire
- Individual Medicare Advantage Plans (MA only) through Empire
Only members enrolled in a plan using preferred CGM edits will need to obtain their CGM systems from a retail or mail order pharmacy. Members on a plan without preferred CGM edits will be able to obtain their CGM systems through durable medical equipment (DME) providers in addition to retail and mail order pharmacies. Please check member and plan benefits to confirm the available delivery channels for accessing CGM products.
November 2020 Empire Provider News