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Diabetes Qualifying

Diabetes Qualifying

Diabetes Qualifying 

Checking A1C

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 
  • 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.

Forms

NOTE: There is no diabetes QE form this year. Diabetes-related questions are included on the general adult Wellness Exam Forms.

Eye Exam

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).

Meet your Diabetes Advocate

Florey Miller, MS, RD, CDE

Registered Dietitian / Diabetes Educator

Florey is a Registered Dietitian/Nutritionist and has been a Certified Diabetes Educator since 1999. Her background includes working as clinical dietitian for Blake Medical Center, as diabetes educator at Doctors Hospital and she had a private practice in a cooking school. Click here to schedule an appointment online.

Florey Miller