Diabetic Supply List — Product Catalog and Coverage Guidance
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A formulary-style list of diabetic supplies typically covered under HealthPartners' diabetic supply benefit; coverage requires a prescription and items not on the list are not covered without prior authorization. Applies to members covered by HealthPartners diabetic supply benefit.
No material clinical or coverage changes in this revision.
Coverage Criteria and Product Catalog
Coverage criteria for diabetic supplies
Covered when ALL of the following are met:
Per policy, non‑listed items are subject to prior authorization and considered not covered without approval.
Item catalog (partial)
Listed items (by brand and specification) included in this section:
Representative SKUs shown in list chunks 18–20.
Product catalog (no criteria)
Itemized product list only; no explicit coverage criteria in this segment.
Product inclusion list
Item list only; no coverage criteria provided in these pages.
Product Listings and Coding Information
| COMFORTOUCH 28G LANCT | COMFORTOUCH 28G LANCT |
| COMFORTOUCH 30G LANCT | COMFORTOUCH 30G LANCT |
| UNIFINE PENTP 5MM 31G | UNIFINE PENTP 5MM 31G |
| UNIFINE PNTIP 4MM 32G | UNIFINE PNTIP 4MM 32G |
| UNIFINE PNTIP 6MM 31G | UNIFINE PNTIP 6MM 31G |
| UNIFINE PNTIP 8MM 31G | UNIFINE PNTIP 8MM 31G |
| UNIFINE PNTP 12MM 29G | UNIFINE PNTP 12MM 29G |
| UNIFINE PNTP 29GX1/2" | UNIFINE PNTP 29GX1/2" |
| UNIFINE PNTP 31GX1/4" | UNIFINE PNTP 31GX1/4" |
| UNIFINE PNTP 31GX3/16 | UNIFINE PNTP 31GX3/16 |
| No codes listed |
| No codes listed |
| No codes listed |
Provider Actions, Prior Authorization, and References
Prior authorization required for non‑listed supplies
Supplies that are not listed on this diabetic supply list are not covered unless prior authorization is obtained; the policy directs providers to use a preferred diabetic supply product when available.
- These products can be purchased through any network pharmacy and require a prescription to be covered.
- Supplies not on this list are not covered and subject to the following prior authorization -' This is not a covered product. Use a preferred diabetic supply product.'
Use the product catalog as claims/procurement reference
Reference the cataloged product list for specific brand/model names and specifications (needles, syringes, lancets, infusion sets, CGM sensors, pen needles, etc.) when ordering or processing claims.
- Includes itemized entries showing needle gauges and lengths, syringe volumes, pen needle sizes, lancets, and infusion set listings.
- Use the listed product descriptions for procurement and claims reference.
Product list (informational only; no PA instructions)
This section lists product names and models for diabetic supplies (brand and SKU‑style descriptors) but does not include prior authorization, documentation, or step‑therapy instructions.
- Entries include lancets, insulin syringes, pen needles, infusion sets and other device models.
- No coverage thresholds, PA instructions, or billing codes are provided in this segment.
Informational product list (itemized SKUs)
Itemized product listing provided for reference; these chunks enumerate specific diabetic supply SKUs and models without stating authorization, documentation, or step‑therapy requirements.
- Shows syringe and pen needle model descriptors (e.g., TECHLITE syringes and pen needles) and includes an update timestamp.
- No explicit prior authorization, documentation, or denial rules are stated in these entries.
Definitions and Product List Notes
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.