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Review Benefits Coverage

patient with doctor

Employee health and wellness is significantly impacted by the healthcare coverage provided by your company. In addition to coverage, wellness education and activities are important contributors to employee health and productivity, particularly for employees with or at risk for diabetes. Workplace health programs are not add-on benefits but basic investments in human capital, similar to training, mentoring, and other employee development programs.

Check your workplace benefits plans to determine if the following are offered:

  • Coverage for Diabetes Self- Management Education (DSME) for people with diabetes.
  • Coverage for a CDC recognized National Diabetes Prevention Program for people with prediabetes.
  • Diabetes related medications.
  • Annual or as needed eye and foot screenings.
  • Regular A1c testing.
  • Routine testing of kidney function, cholesterol, and high blood pressure.

The American Diabetes Association and the American Association of Clinical Endocrinologists provide Standards of Care — detailed information about appropriate medical care for people at risk for diabetes or with diabetes.

Many employers try to manage their benefits programs together rather than using a siloed approach.  Employers promote a healthy workforce by managing medical, absence and disability programs together.  Often multiple chronic conditions are addressed in benefit plans.

Aids & Tools

Know More

    1. Integrated Benefits Institute (IBI) Supports employers and their partners with research, tools, benchmarking and case studies. IBI has done research on the Impact of Chronic Health Conditions and Co-morbidity on Lost Work Time and examines the implications for treatment and management of these health conditions found in the workforce.
    2. CDC’s Workplace Health Promotion gives more resources about benefits.
    3. National Business Group on Health: Diabetes webpages.
    4. The Centers for Disease Control also has resources within the Total Worker Health Initiative.
    5. The National Business Coalition on Health eValue8 has materials about the health plans’ performance on recommended benefits.

Ask More

  1. How are the recommended benefits for people with diabetes determined?
    Answer:
    Diabetes medical professionals and scientists regularly monitor health outcomes among people with diabetes and generate the guidelines for best treatment practices.  Insurance companies are encouraged to provide coverage for their enrollees with diabetes based on these standards of care.
  2. Our health insurance vendor considers insulin pumps and continuous glucose monitors “experimental”. Is this true?
    Answer:
    The American Diabetes Association advocacy department can help employers work with their health care insurance provider to identify the best coverage.  
  3. What are the recommendations for coverage for women with gestational diabetes?
    Answer:
    Insurance coverage should allow a woman with gestational diabetes to keep blood sugar levels equal to those of a pregnant woman without gestational diabetes. Treatment may include special meal plans and scheduled physical activity as well as daily blood glucose testing and insulin or other medications.  Additional medical care appointments may also be required.
  4. How often do the recommendations for coverage change and how will I know if there are new standards of care for diabetes?
    Answer:
    The Standards of Care [PDF – 2.8 MB] for the treatment of diabetes are reviewed annually by the American Diabetes Association.

Do More

  1. Conduct a medical benefits review.
  2. Talk with employees who have diabetes to assess their satisfaction with the health coverage provided by your company.
  3. Consult with your HR department and senior leadership if additional benefits are needed.

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