Abbott Test Strips (e.g. FreeStyle Insulinx, FreeStyle Lite, FreeStyle, FreeStyle Precision Neo, Precision Xtra) — United Healthcare
Diabetes (use of diabetic meters and test strips)
Preferred products
- OneTouch Ultra 2 Meter (OneTouch Ultra Test Strips)
- OneTouch Verio Flex Meter (OneTouch Verio Test Strips)
- OneTouch Verio Reflect Meter (OneTouch Verio Test Strips)
- Contour Next One Meter (Contour Next Test Strips)
- Contour Next EZ Meter (Contour Next Test Strips)
- Contour Next Gen Meter (Contour Next Test Strips)
- Accu-Chek Guide Meter
- Accu-Chek Guide Me Meter
- Accu-Chek Guide test strips
- Contour Next test strips
- Contour Next Meter
Initial criteria
- Submission of medical records documenting a physical or mental limitation that makes utilization of one of the preferred diabetic meters/test strips unsafe, inaccurate, or otherwise not feasible (e.g. manual dexterity)
- Preferred diabetic meters/test strips include ALL of the following: OneTouch Ultra 2 Meter (OneTouch Ultra Test Strips) AND OneTouch Verio Flex Meter (OneTouch Verio Test Strips) AND OneTouch Verio Reflect Meter (OneTouch Verio Test Strips) AND Contour Next One Meter (Contour Next Test Strips) AND Contour Next EZ Meter (Contour Next Test Strips) AND Contour Next Gen Meter (Contour Next Test Strips)
Approval duration
12 months