nonpreferred glucose cartridge — Blue Cross Blue Shield of Alabama
diabetes requiring blood glucose monitoring
Preferred products
- Abbott products
- Ascensia products
Initial criteria
- ONE of the following must be met:
- - Medication history of use in the past 90 days to ONE prerequisite (preferred) agent OR
- - Visual impairment OR
- - Insulin pump or continuous glucose monitor (CGM) not accommodated with a prerequisite agent OR
- - Physical or mental disability
Approval duration
12 months