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Best Health Insurance for Diabetes in California

If you have diabetes, choosing the right health plan can save you thousands of dollars on insulin, supplies, and care. Learn how to compare Covered California plans for the best diabetes coverage.

What's Covered for Diabetes

All Covered California plans must cover diabetes care as an Essential Health Benefit. This includes:

  • Insulin: All types covered, though costs vary by plan tier
  • Testing supplies: Blood glucose meters, strips, lancets
  • Medications: Metformin, other diabetes drugs
  • Preventive services: Annual diabetes screenings (free)
  • Specialist visits: Endocrinologists, diabetes educators
  • Eye exams: Annual diabetic retinopathy screening

Insulin Costs by Plan Type

Insulin costs vary significantly by plan. Here's what to expect:

Plan Tier Generic Insulin Brand Insulin Monthly Estimate*
Bronze $20-30 copay 20-30% coinsurance $100-200+
Silver $15-25 copay 20-25% coinsurance $75-150
Gold $10-20 copay 15-20% coinsurance $50-100
Platinum $5-15 copay 10-15% coinsurance $30-75

*Estimates based on typical usage. Actual costs depend on specific insulin type and plan.

Cost-Saving Tip: California capped insulin copays at $35/month for many plans. Check if your plan includes this cap.

Supplies & Testing Coverage

Diabetes supplies are typically covered under the prescription drug benefit:

  • Blood glucose meters: Often covered as durable medical equipment
  • Test strips: Usually covered under pharmacy benefit
  • Lancets: Covered under pharmacy or DME benefit
  • Continuous Glucose Monitors (CGM): Covered with prior authorization
  • Insulin pumps: Covered as durable medical equipment
Important: Some plans require using specific pharmacies or mail-order for best pricing on supplies.

Best Plans for People with Diabetes

The best plan depends on your specific situation:

Enhanced Silver Plans

Best for: Lower-income individuals (under 250% FPL)

  • Lower drug copays through CSR
  • Reduced specialist copays
  • Lower out-of-pocket maximums
Gold Plans

Best for: Those who don't qualify for CSR

  • Lower drug copays than Silver
  • No deductible before coverage
  • Predictable costs for regular care

Diabetes Management Programs

Many Covered California carriers offer diabetes management programs at no extra cost:

  • Kaiser Permanente: Comprehensive diabetes care teams, classes, and online resources
  • Blue Shield: Wellvolution diabetes prevention and management programs
  • Anthem: LiveHealth Online diabetes coaching
  • Health Net: Diabetes disease management with nurse support

Ask your carrier about available programs when you enroll.

Need Help Finding the Right Plan?

Our agents can help you compare diabetes coverage across all carriers.

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