My Diabetes Information Blogs
Is Your Health Plan Helping You Manage Diabetes?
01/19/09
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California managed care organizations need to do a better job of monitoring diabetes.
Do you know how well your managed care organization manages diabetes? HMOs, PPOs, health plans and health insurance companies all comprise the world of managed care. The National Committee for Quality Assurance (NCQA) is an organization that accredits HMOs and other health insurers. You can look up a report on many health benefits providers and insurers.
Early in the history of the NCQA it looked at how health insurance organizations helped patients manage diabetes. When you find your health insurer, click on "More Details" under the column "Living with Disease." The next page will tell you if your health insurance organization provided:
- Hemoglobin A1C testing
- Eye exams
- LDL cholesterol testing
- Kidney testing
It's not the insurance company's job to make sure you get the diabetes care you need. It's a responsibility that you share with your doctor. However, you should ask yourself if your insurance company pays for these services and makes it easy for you to get them. If there is a lack of eye doctors on your panel? Do they refuse payment on preventative diabetes services, or encourage you to get them?
In addition to the list of tests above, we encourage you to have foot exams, and ask your doctor to order blood tests that include blood lipid and cholesterol readings. We hope your insurance company also pays for more than enough diabetic testing supplies to test your blood sugar aggressively.