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Commercial Coverage Landscape: Payer List
This page lists the commercial health plans that cover the National Diabetes Prevention Program (National DPP) lifestyle change program for all or a subset of their lines of business. The managers of this website make every attempt to keep this information up to date. However, information is provided with the understanding that it is not guaranteed to be correct or complete and conclusions drawn from this information are the responsibility of the user. This page is updated quarterly in January, April, July, and October. If you have information or coverage updates for any payers, please let us know by filling out the Add or Update a Payer or Employer Form at the bottom of this page.
Participating Commercial Health Plans
The following list is based on publicly available data and may not be inclusive of all health plans that include the National DPP lifestyle change program as a covered benefit. Listed plan sponsors may not cover the program for all lines of business. By clicking any plans that are linked below you will be directed to a case study that tells the story of that plan offering the program to their members.
- Aetna (DE)
- Aetna Better Health of Kentucky
- AlohaCare
- AmeriHealth Caritas Partnership
- Anthem Blue Cross (CA)
- Anthem Blue Cross Blue Shield (CO)
- Anthem Blue Cross Blue Shield (KY)
- Aspire Health Plan (CA)
- Blue Cross Blue Shield of Idaho
- Blue Cross Blue Shield of Illinois
- Blue Cross Blue Shield of Kansas City
- Blue Cross Blue Shield of Louisiana
- Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Michigan
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of Nebraska
- Blue Cross Blue Shield of North Carolina
- Blue Cross Blue Shield of North Dakota
- Blue Cross Blue Shield of Ohio
- Blue Cross Blue Shield of Rhode Island
- Blue Cross Blue Shield of Texas
- Blue Cross Blue Shield of Western New York
- Blue Shield of California
- Capital District Physicians’ Health Plan
- CareFirst BlueCross BlueShield (MD, VA, and Washington, D.C.)
- Cigna
- Denver Health Medical Plan, Inc.
- EmblemHealth
- Express Scripts
- EMI Health
- Florida Blue
- GEHA
- Geisinger Health Plan (PA)
- Group Health Cooperative of South Central Wisconsin
- Hawaii Medical Assurance Association
- Hawaii Medical Service Association
- Health Net
- HealthPartners (PA)
- Highmark Blue Cross Blue Shield Delaware
- Highmark Blue Cross Blue Shield Pennsylvania
- Highmark Blue Cross Blue Shield West Virginia
- Humana
- Independent Health
- Kaiser Permanente (CA, CO, GA, HI)
- L.A. Care
- Medical Mutual of Ohio
- Molina Healthcare
- Network Health
- Pacific Source
- Priority Health
- Sanford Health Plan
- Quartz
- San Francisco Health Service System
- SelectHealth
- Security Health Plan
- SHARP Health Plan
- Tufts Health Plan
- UnitedHealthcare
- University Health Alliance (HI)
- Western Health Advantage (CA)
Resources for commercial health plans and employers about covering the National DPP lifestyle change program are available here.
Commercial Health Plan Case Studies
Blue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of Minnesota offers the program with no cost-sharing for their members. To learn more about their approach, please read this short article, Blue Cross and Blue Shield of Minnesota Expands No-Cost Access to Diabetes Prevention Programs, Starting in 2024.
Blue Cross Blue Shield of North Carolina
Blue Cross Blue Shield of North Carolina, through community funding, offers the National DPP lifestyle change program to all eligible North Carolinians regardless of insurance status through 2023. The Eat Smart, Move More, Prevent Diabetes Program is available through distance learning, as well through select onsite providers across the state.
Express Scripts
Express Scripts is a Pharmacy Benefit Manager (PBM) that provides coverage for the National DPP lifestyle change program through their SafeguardRxSM platform. They provide coverage for the program to their patients similarly to how payers provide the program to members.
Florida Blue
Florida Blue is the largest commercial health plan in Florida, providing insurance to individuals under 65, Medicare Advantage plans, and commercial group plans. It began offering the National DPP lifestyle change program to its employees in 2013 and expanded the program to Florida Blue members statewide in 2014.
As of December 2016, the National DPP lifestyle change program was available to 20 employer groups. 1,055 people had attended at least one session, of which 805 (76%) attended at least four sessions and 545 (52%) attended at least nine sessions. 107 (31%) of these participants had achieved the weight loss goal of 5% or more.
In 2017, Florida Blue began offering the program to Medicare Advantage beneficiaries, and as a wellness program for fully-insured commercial group members.
Florida Blue has promoted awareness and access to the National DPP lifestyle change program in a variety of ways, including:
- Providing statewide access to its in-person diabetes prevention classes through its provider- and Care Consultant-staffed community-based retail centers.
- Engaging with physicians and facilitating referrals in Patient Centered Medical Homes (PCMHs). To improve flexibility in participation, Florida Blue has allowed referred individuals in PCMHs to partake in lifestyle change classes at a physician practice or a YMCA.
- Forging partnerships with Solera Health and the YMCA of the USA to expand choice and minimize barriers to participation. With these partners, the program has been offered online, as well as in-person at numerous locations throughout the state, including employer worksites.
More information about Florida Blue’s coverage for the National DPP lifestyle change program can be found here.
If there are additional health plans covering the National DPP lifestyle change program for their members that have not been included above, or if you have coverage updates for any health plans included above, please let us know by filling out the Add or Update a Payer or Employer Form at the bottom of this page.
Add Or Update a Payer or Employer
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