Glucose Monitoring and Insulin Delivery Devices for Managing Diabetes

This policy covers glucose monitoring (home blood glucose meters, professional 72‑hour interstitial monitoring, and long‑term CGM when criteria are met) and external insulin delivery devices and related supplies (insulin pumps, infusion sets, injection aids, footwear for diabetic foot care) for management of Type 1, Type 2, and gestational diabetes and for specified pediatric patients (including children with neuromuscular, neurological, or cognitive impairments and the legally blind). Coverage is limited to fully insured PPO/HMO/POS plans in Illinois effective 2025‑01‑01 (not self‑insured/ERISA/ASO unless specified), requires FDA‑labeled devices and meeting specified clinical criteria (ability to use device, medical supervision, insulin treatment or significant hypoglycemia for CGM), limits professional monitoring to 72 hours, and excludes experimental/unproven devices and non‑covered convenience items.

"Coverage of therapy for children clinically or genetically diagnosed with a disease, syndrome, or disorder that includes low tone neuromuscular impairment, neurological impairment, or cognitive imp..."