Meridian MI Medicaid – Diabetic Supply Reference Guide Update for 2025
Meridian is updating the Meridian Michigan Medicaid Diabetic Supply Information & Reference Guide for 2025. In the past, with previous bulletins and communications from Meridian in 2024 we highlighted specific diabetic supplies, and indicated these supplies were covered by the member’s pharmacy benefit and/or medical benefit.
We have created this resource to provide clarification on the specifics of coverage for diabetic supplies and any prior authorization requirements. Please reach out to your provider representative with any questions you may have regarding diabetic supply coverage for Meridian Michigan Medicaid members. For questions specific to pharmacy benefits, you can also call Meridian’s pharmacy department at 866-984-6462 with questions.
Please refer to the table below for information regarding diabetic supply products, available benefit types where diabetic supplies are covered, dispensing routes, and additional information.
Product: | Current Benefit Type: | Dispensed by: | Additional Information |
|---|---|---|---|
Continuous Glucose Monitor components including sensors, transmitters, receivers (Dexcom, Freestyle Libre, Guardian, Eversense) | Pharmacy or Medical | Pharmacy or DME | - Prior authorization required under pharmacy benefits - Prior authorization required under medical benefits |
Wearable insulin delivery system (Omnipod, V-Go, Cequr) | Pharmacy or Medical | Pharmacy or DME | - Prior authorization required under pharmacy benefits - Prior authorization required under medical benefits |
Traditional Insulin Pumps (iLet, Medtronic, Tandem t:slim) | Medical | DME | - Prior authorization required under medical benefits |
Blood Glucose Test Strips | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits for preferred product OneTouch Verio Test Strips for claims within the Quantity Limit of 250 strips per 30 days - Prior authorization required under pharmacy benefits for other test strip brands as nonpreferred products - Prior authorization NOT required under medical benefits |
Blood Glucose Glucometers | Pharmacy(*) or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits for preferred product OneTouch Verio Flex Meter(*) - (*)All Glucometers including OneTouch Verio Flex Meter will reject at pharmacy point of sale - Pharmacy rejection message redirects to billing information for free OneTouch Verio Flex Meter from manufacturer - Prior authorization required under pharmacy benefits for other glucometers as nonpreferred products - Prior authorization NOT required under medical benefits |
Lancets | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits - Many preferred brands under pharmacy benefits (such as OneTouch, Accu-chek) - Prior authorization NOT required under medical benefits |
Insulin Syringes & Pen Needles | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits for preferred products. - Effective 8/1/2025, preferred products for MI Meridian Medicaid insulin syringes and pen needles are Embecta branded syringes and pen needles (formerly known as BD brand). This applies to pharmacy benefit only - Prior authorization NOT required under medical benefits |
Alcohol Prep Pads | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits - Prior authorization NOT required under medical benefits |
Ketone Urine Test Strips | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits for claims within the Quantity Limit of 100 strips per 30 days - Prior authorization required under pharmacy benefits for claims greater than the Quantity Limit of 100 strips per 30 days. - Prior authorization NOT required under medical benefits |
Protein Urine Test Strips | Medical | DME | - Prior authorization NOT required under medical benefits |
Glucometer Control/Calibration Solutions | Pharmacy or Medical | Pharmacy or DME | - Prior authorization NOT required under pharmacy benefits - Prior authorization NOT required under medical benefits |
Footnotes
- Pharmacy benefit prior authorizations can be initiated either to fax number 877-355-8070, or electronic prior authorization completed online through covermymeds.com
- For blank prior authorization forms, pharmacy resources and formulary information please visit the Provider Pharmacy page
- Medical benefits prior authorizations can be initiated either to fax number 833-341-2049, or online through the secure Provider Portal
- Medical benefit procedure codes (CPT codes) coverage status can be verified online through Meridian’s website with the Medicaid Pre-Auth Check Tool; Select “NO” for each answer to the questions for Types of Services, then enter the code of the service you would like to check