Contour test strips — CareFirst (Caremark)
diabetes requiring glucose monitoring using test strips
Preferred products
- Accu-Chek products
- True Metrix products
Initial criteria
- Patient cannot be treated with a preferred product (Accu-Chek or True Metrix products).
- ONE of the following:
- For Contour test strip product: requested test strips are for use in association with a MiniMed insulin pump OR OmniPod Dash insulin pump (documentation required).
- For Freestyle test strip product: requested test strips are for use in association with an OmniPod insulin pump OR a Freestyle Continuous Glucose Monitor (CGM).
- For non-Contour or non-Freestyle test strip products: patient has an insulin pump that is incompatible with an Accu-Chek OR a True Metrix product.
Approval duration
12 months