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May 1, 2019

Pharmacy coverage added for Freestyle Libre for commercial members

Pharmacy benefit coverage for Commercial members will be updated effective May 1, 2019 to include coverage of the Abbott Freestyle Libre System for members who may benefit from continuous glucose monitoring. The Libre system, including readers and 14-day sensor kits, will be available through the participating pharmacy network. The product will be available for insulin users only – a system edit will employ a claims system look-back of 120 days to identify insulin use. Coverage will be allowed for 2- – 14-day sensors per 28-day supply. The initial dispensing will require a separate prescription for the Libre reader and the 14-day sensor kit. The Libre reader and sensors will be added to the commercial formulary at a non-preferred brand copay tier.