Wellcare CalViva Health Dual Align (HMO D-SNP): Diabetes Self-Management Training, Diabetic Services and Supplies

For those who already have diabetes, whether insulin users or non-insulin, it typically takes a number of self-management techniques and a variety of supplies to adequately manage it and prevent complications.  Monitoring blood sugar (glucose), maintaining a healthy diet, getting plenty of activity, caring for skin and feet, and other proactive methods are required, the costs of which are greatly covered by the health plan.

Monitoring diet requires an understanding of food labels for sugar and carbohydrates, understanding and selecting healthy alternatives (such as fresh vegetables over junk food and seltzers over sodas), meal planning, smart choices when dining out, scheduling intake in coordination with blood glucose levels, and recording them in conjunction.  This education takes time and effort and is likely in the form of written or digital aids.  Diabetes self-management training is covered under certain conditions, which may include in-person and online visits and tools.

Monitoring activity/exercise requires not only motivation but also know-how.  The type and level of activity/exercise best for one’s body type (height, weight, habitus), understanding how activity/exercise affects sugar levels and knowing warning signs, recognizing activities that are riskier for those with diabetes, scheduling activity in coordination with blood glucose levels, and recording them in conjunction.  This education also takes time and effort and likely written or digital aids.  Diabetes self-management training is covered under certain conditions, which may include in-person and online visits and tools.

Understanding, as well, how illness and medications affect blood glucose levels is essential.

Monitoring blood glucose requires a blood glucose monitor, glucose-control solutions for testing equipment accuracy, blood glucose test strips, lancet devices, and lancets.  The plan’s chosen brand for diabetes monitoring and testing supplies is Ascensia/Bayer Diabetes Care and must be obtained from an in-network pharmacy.  All other branded products require plan approval (prior authorization) for coverage.

Unfortunately, some people with diabetes will develop severe diabetic foot disease and require special, therapeutic custom-molded shoes.  The plan covers one pair per calendar year, including two additional pairs of inserts OR one pair of extra depth shoes and three pairs of inserts.  This coverage includes professional fitting.