Large, private U.S. health plans cover many diabetes services and supplies, whether or not the plans are required to do so by state laws or rules.[@@]
A team of U.S. Government Accountability Office researchers led by Karen Iritani has published data supporting that conclusion in a report on commercial plan diabetes benefits.
Reps. Joe Barton, R-Texas, and Fred Upton, R-Mich., requested the report.
All 3 of the 3 largest health plans participating in the Federal Employees Health Benefits Plan and 13 of the largest employers’ self-funded plans cover most of the diabetes services required by patients, and in most cases they put no limitations on that type of coverage, Iritani and her colleagues write in the report.
Each of the 3 federal plans and each of the 13 self-funded plans contacted by the GAO for its study covered at least 7 of 10 diabetes services needed by most patients, including an annual blood glucose test, cholesterol and blood pressure monitoring, and influenza vaccinations.
Services covered less often included diabetes education, medical nutrition therapy, and smoking cessation therapy.
All 16 plans contacted by the agency also covered at least 5 of the 9 diabetes supplies Iritani’s team reviewed, including insulin and insulin-administering supplies. Most of these plans also covered blood glucose monitors, glucose control solutions, alcohol swabs and therapeutic shoes.
In 2004, the year of the study, 47 states had laws or rules related to coverage of diabetes services or supplies, although the specific coverage requirements varied by state, Iritani’s team says.
The most common state diabetes mandates concern diabetes education and diabetes medical nutrition therapy, according to Iritani’s team.
The GAO has posted a copy of the report at http://www.gao.gov/new.items/d05210.pdf