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Diabetes Pharmacy Benefit & Rewards

You, your spouse, and your dependents can earn cash rewards through a quarterly payroll payout to offset your diabetes medication and supply costs if you:

  • Are a Cone Health medical plan member.
    • Save Plan participants are eligible for rewards only after meeting their deductible. Also, diabetes medications (not supplies) are covered under the Safe Harbor benefit, which allows Save Plan members to get diabetes medications at the Choice and Focus Plan copay before deductible is met.

Diabetes Copays

Download the diabetes estimated copay card chart [PDF].

How the Program Works

  1. When getting your diabetes medications at the pharmacy, you'll have to pay for any cost that remains after the pharmacy applies eligible manufacturer copay cards. (Consider increasing your spending account contributions to help cover these costs.)
  2. Cone Health Outpatient Pharmacies will then report your total out-of-pocket costs for all approved diabetes prescriptions to payroll. You won't need to submit pharmacy receipts.
  3. On one paycheck per quarter, you'll receive a reward equal to your costs (or those of your spouse or dependents) minus payroll taxes. The IRS classifies money reimbursed to you for healthcare expenses as taxable income.

Diabetes Supplies Covered

In addition to covering approved medications, the Diabetes Pharmacy Benefit and Rewards Program covers test strips, lancets, pen needles, and syringes. Freestyle test strips and lancets are the preferred, covered products for testing blood glucose. If you use an insulin pump, the plan covers Contour test strips. You'll get pump supplies through your medical plan.

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