Questions to Ask When Enrolling in a New Insurance Plan

It’s important to ask questions when enrolling in a new insurance plan to make sure that you understand your coverage.

That way, you can feel confident knowing what tools you have at your disposal as you manage your diabetes and navigate the healthcare system.

Here are some questions to get you started:

1. Coverage for Diabetes Medications and Supplies

• What does coverage look like for...

• • Insulin (vials, pens), oral medications, injectable medications?

  • Continuous glucose monitors (CGMs) and insulin pumps? 

  • Glucagon, specifically ready-to-use options?
  • Pen needle caps, syringes, test strips, lancets, glucose meters?

• Will I need a letter of medical necessity or prior authorization to have the above items covered by my plan?

2. Access to Specialists and Diabetes Educators

• Are there restrictions on seeing endocrinologists or diabetes specialists? Do I need a referral?

• Are my current providers in-network?

• Does the plan cover visits to diabetes educators or nutritionists to support my diabetes management?

3. Preventive Care & Screenings

• What preventive services related to diabetes, such as regular blood work, eye exams, or dental work are covered by the plan? Do I need separate coverage for vision and dental?

• Are there any specific guidelines or requirements for preventive care in managing diabetes?

4. Hospitalization and Emergency Care

• What hospitals near me are in-network?

• Is there a copay or coinsurance for emergency room visits? If so, how much?

• How does my plan handle emergency services if I am traveling or outside my coverage area?

5. Additional supports:

• What options are available for diabetes wellness programs? Are any incentives available?

• Are there any case managers or patient advocates available if I need support in navigating insurance challenges?