In order to qualify for the BEST or ULTIMATE Health Plan Levels, members age 19 and older with Diabetes must complete qualifying requirements each year. Refer to the Diabetes Qualifying booklet for details.
ALL members with diabetes wanting to qualify for the BEST or ULTIMATE Plan Level must:
- Obtain Quest Blueprint for Wellness labs and urine microalbumin test
- Receive a physical/wellness exam, including a foot exam, by your primary care physician
- Complete age-based screenings (refer to Wellness Exam form)
- Have an annual dilated eye exam by an ophthalmologist or optometrist (use Medical card, not Vision card)
- Choose and complete Diabetes Qualifying Choices based on 2020 A1C (If you did not complete annual county lab work in 2020, your 2019 A1C value will be used to determine Qualifying requirements.) OR for those newly diagnosed (from 6/1/19 to 5/31/21) or new on the plan (since 9/1/2019 to present) complete the Survival Skills classes.
- Diabetes Qualifying Form for Newly diagnosed/New Enrollees
- Diabetes Qualifying Form
- Diabetes Qualifying Log Form (for A1C 9.0 and above)
- Diabetes Exercise Log
Why is it so important to have a yearly dilated eye exam for people with diabetes?
High blood sugar can damage the small vessels in the eye and cause several problems including blindness. There are usually no symptoms. That is the reason the American Diabetes Association recommends each person with diabetes have a dilated eye exam once a year to catch minor problems before they become big ones.
This is not a vision exam to check if you need glasses. During the dilated eye exam, the doctor looks at the back of your retina to determine if there are any problems with the small veins and capillaries located in the retina. Therefore, please use your medical insurance card, not your vision card.
You can visit either an ophthalmologist or optometrist and there is no copay for this exam. Refer to the Aetna Provider Directory to find an in-network provider (Aetna Choice POSII (Open Access) Network).