Diabetes care you can count on

Frequently Asked Questions

• Where is the plan available?

  • Our Diabetes Care Plan is available in Arizona, Florida, Georgia , Iowa, Illinois, Kansas, Missouri, North Carolina, Nebraska, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

• Who is eligible for the plan?

  • This plan is available in Arizona, Florida, Georgia , Iowa, Illinois, Kansas, Missouri, North Carolina, Nebraska, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

    Enrollment into the plan is not limited to diabetic members and the lower cost shares for non-diabetic related services and supplies (labs, PCP visits, Tier 1a drugs) are not restricted based on a member having a specific chronic condition.

• Is the plan designed for people with type 1 and type 2 diabetes?

  • Yes, this plan can help save money and manage the condition for people living with type 1 or type 2 diabetes. If you have pre-diabetes or gestational diabetes, this plan may offer reduced costs, but you will not be eligible to engage in the rewards and incentives program offerings for members living with diabetes.

• What benefits are included with the plan ?
  • The Diabetes Care Plan includes:

    • $0 Primary doctor visits
    • $0 Behavioral health visits
    • $0 Endocrinologist visits
    • $0 Labs (including HbA1C screening, urinalysis, metabolic panel, lipid panel)
    • $0 Diabetic eye and foot exams
    • $100 out-of-pocket monthly maximum on insulin
• What insulin brands and durable medical equipment (DME) manufacturers are included or covered in the plan?

  • Accu-Chek® is Oscar's preferred brand for diabetic testing supplies (meters, test strips, lancets). Preferred brands for insulin are Basaglar, Tresiba, Levemir, Humulin U-500, Fiap, and Novolin/Novolog.

• Which glucose monitors are included?
  • Dexcom G6 and G7 are Oscar’s preferred continuous glucose monitors (CGM) and are also available to members through prior authorization. See here for Oscar's medical necessity criteria for CGMs. The devices are enabled by Bluetooth® and easily connect to the mySugr app.
• How do I get my diabetic testing supplies?

  • Use the pharmacy benefits built into the plan to request refills of diabetic testing supplies (meters, test strips, lancets) or insulin.

• What rewards and incentives are included?
  • Members living with type 1 or type 2 diabetes and enrolled in the Diabetes Care plan can earn:

    • $30 for switching a qualifying brand name drug from 30-day to 90-day refill
    • $50 toward healthy groceries by completing an annual wellness exam
    • Access to gyms and on-demand fitness by the American Specialty Health Fitness’ Active&Fit program by completing any two routine services (like labs and a diabetic eye exam)

    Members who are not currently living with diabetes, are pre-diabetic, or live with gestational diabetes are not eligible for these rewards and incentives. Be sure to check our Perks page for additional rewards and incentives that may be available to you.
• How will Oscar know if I completed the actions for the rewards and incentives?

  • Once you complete an activity, the claim from your visit (or prescription refill) will serve as verification of completion and you will be sent your gift card.

• Do my rewards expire?

  • Please refer to any applicable expiration details provided at the time you receive a reward.

• If I participate in earning rewards and incentives with this plan, am I excluded from earning other rewards and incentives offered with my Oscar plan?
  • No, it does not exclude you from other rewards and incentives programs. Check our Perks page for additional rewards and incentives that may be available to you.
• I have not received my rewards yet, who should I contact?
  • If you have not received your rewards, you can call your Care Team at (855) 672-2755.
• What is the difference between the Diabetes Care Plan and WellDia?

  • The Diabetes Care Plan is a medical plan option offered through Oscar that includes primary care, specialist care, $0 services, and more that are focused on supporting members living with type 1 or type 2 diabetes. This plan may also be a good fit for those with pre-diabetes or gestational diabetes.

    Members use the pharmacy benefits built into the plan to request refills of diabetic testing supplies (meters, test strips, lancets) or insulin.

    WellDia is Oscar’s diabetes management program, helping members manage their type 1 or type 2 diabetes and stay on top of regular blood glucose testing. WellDia members receive $0 Accu-Chek® test strips, lancets, and a new glucometer. WellDia is offered at no cost to you. You must be enrolled in an Oscar medical plan and have type 1 or type 2 diabetes to be eligible for WellDia.

• Can I enroll in the Diabetes Care Plan and WellDia?

  • Yes, you can enroll in the Diabetes Care Plan and WellDia. You must be enrolled in an Oscar medical plan and have type 1 or type 2 diabetes to enroll in WellDia.