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Y0040_GHHKBXREN_20_C Your Humana Medicare Advantage Plan covers a variety of diabetic glucose testing supplies. Humana Pharmacy ® is the preferred durable medical equipment (DME) vendor for these products, and offers the meters listed below, and their test strips and lancets at a $0* cost share. HP ® TRUE METRIX ® AIR by Trividia • Bluetooth ® Technology • No coding • Tiny, 0.5-microliter sample size • Results in four seconds Roche Accu-Chek Aviva ® • Small, 0.6-microliter sample size • Results in five seconds • Test on multiple sites on the body Roche Accu-Chek Guide Me ® • Bluetooth ® Technology • Small, 0.6-microliter sample size • Results in four seconds Roche Accu-Chek Guide ® • Bluetooth ® Technology • Small, 0.6-microliter sample size • Results in four seconds *If your plan has a medical deductible—a dollar amount you pay up to each year before you receive coverage—it must be met to be eligible for $0 cost share for supplies. You can also receive the meter and test strips through other durable medical equipment providers or pharmacies, but standard Part B coinsurance will apply. Did you know your diabetic supplies are covered under your medical benefit, even though you get them from the pharmacy? To order a meter and supplies from Humana Pharmacy call, 1-877-222-5084 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time. Your doctor can also send prescriptions for meters and other testing supplies by fax or e-prescribe. You can also request a no-cost meter from the manufacturer by calling Roche at 1-888-355-4242 (TTY: 711), or Trividia Health 1-866-788-9618 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time. This applies to Humana-covered Medicare Advantage members only. It does not apply to Humana-covered prescription drug plan (PDP-only) members, as diabetic testing supplies are covered under Part B. Other pharmacies are available in our network.

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Page 1: Your Humana Medicare Advantage Plan covers a variety of

Y0040_GHHKBXREN_20_C

Your Humana Medicare Advantage Plan covers a variety of diabetic glucose testing supplies. Humana Pharmacy® is the preferred durable medical equipment (DME) vendor for these products, and offers the meters listed below, and their test strips and lancets at a $0* cost share.

HP® TRUE METRIX® AIR by Trividia• Bluetooth® Technology• No coding• Tiny, 0.5-microliter

sample size• Results in four seconds

Roche Accu-Chek Aviva®

• Small, 0.6-microliter sample size

• Results in five seconds• Test on multiple sites on

the body

Roche Accu-Chek Guide Me®

• Bluetooth® Technology• Small, 0.6-microliter

sample size• Results in four seconds

Roche Accu-Chek Guide®

• Bluetooth® Technology• Small, 0.6-microliter

sample size• Results in four seconds

* If your plan has a medical deductible—a dollar amount you pay up to each year before you receive coverage—it must be met to be eligible for $0 cost share for supplies. You can also receive the meter and test strips through other durable medical equipment providers or pharmacies, but standard Part B coinsurance will apply.

Did you know your diabetic supplies are covered under your medical benefit, even though you get them from the pharmacy?

To order a meter and supplies from Humana Pharmacy call, 1-877-222-5084 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time.

Your doctor can also send prescriptions for meters and other testing supplies by fax or e-prescribe. You can also request a no-cost meter from the manufacturer by calling Roche at 1-888-355-4242 (TTY: 711), or Trividia Health 1-866-788-9618 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time.

This applies to Humana-covered Medicare Advantage members only. It does not apply to Humana-covered prescription drug plan (PDP-only) members, as diabetic testing supplies are covered under Part B.

Other pharmacies are available in our network.

Page 2: Your Humana Medicare Advantage Plan covers a variety of

Y0040_GHHKBXREN_20_C

Important! _________________________________________________________________________________At Humana, it is important you are treated fairly. Humana Inc. and its subsidiaries do not discriminate or exclude people because of their race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. Discrimination is against the law. Humana and its subsidiaries comply with applicable Federal Civil Rights laws. If you believe that you have been discriminated against by Humana or its subsidiaries, there are ways to get help. • You may file a complaint, also known as a grievance:

Discrimination Grievances, P.O. Box 14618, Lexington, KY 40512-4618 If you need help filing a grievance, call the number on your ID card or if you use a TTY, call 711.

• You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD).

Complaint forms are available at https://www.hhs.gov/ocr/office/file/index.html.

Auxiliary aids and services, free of charge, are available to you. Call the number on your ID card (TTY: 711)Humana provides free auxiliary aids and services, such as qualified sign language interpreters, video remote interpretation, and written information in other formats to people with disabilities when such auxiliary aids and services are necessary to ensure an equal opportunity to participate.

Language assistance services, free of charge, are available to you. Call the number on your ID card (TTY: 711)


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