Ninety-Day Dispensing Now Available for Blood Glucose Monitoring Supplies

Thursday, January 25, 2024

Continuous glucose monitoring systems (CGMS) allow ongoing, real-time monitoring and recording of blood glucose levels at set intervals, which can be helpful for diabetic patients who need to closely track their blood glucose levels. To align with current practices for blood glucose monitoring supplies, retroactive to Jan. 1, 2024, TRICARE has changed the prescribing policy for CGMS supplies from 30-day dispensing to 90-day dispensing. Note: Any denials for 30-day supplies under the medical benefit will be revised to reflect 90-day supplies.

Coverage Overview

CGMS supplies are covered as durable medical equipment under the medical benefit managed by Health Net Federal Services, LLC and as a pharmacy benefit under the TRICARE Pharmacy Program managed by Express Scripts®. Important: Limitations and guidelines differ between TRICARE’s pharmacy and medical benefits.

TRICARE Medical Benefit Coverage

Refer to TRICARE Policy Manual, Chapter 8, Section 5.3, Paragraph 4.0 for beneficiary coverage requirements. For details on covered supplies, visit our Diabetic Supplies and Equipment page.

TRICARE Pharmacy Benefit Coverage

For information on TRICARE pharmacy benefit coverage, visit TRICARE's Pharmacy page or Express Scripts’ website at www.militaryrx.express-scripts.com. For direct access to the TRICARE Formulary Search Tool, visit www.esrx.com/tform.