Based on industry updates, NaviCare coverage for Contour Next Gen glucose strips in Massachusetts depends on your plan’s approved supply list. These strips are not always listed as a preferred brand, but members may still get coverage if their healthcare provider submits documentation of medical necessity and the strips are purchased from an in network supplier. Always confirm with NaviCare Member Services before ordering.
What Is NaviCare and Who Qualifies in Massachusetts
NaviCare is a specialized health plan for Massachusetts residents who qualify for both Medicare and MassHealth. It is offered through Fallon Health and designed for older adults or individuals who need long term care services.
Many members rely on this plan for coverage of prescriptions, durable medical equipment (DME), and essential diabetic supplies such as glucose meters and test strips.
NaviCare offers two main plan types:
- NaviCare HMO SNP – For people who have Medicare and MassHealth Standard.
- NaviCare SCO (Senior Care Options) – For people who have MassHealth Standard but not Medicare.
Both plans include extra benefits like vision, hearing, dental, and in some cases, an over-the-counter allowance that can be used for select medical supplies.
What Are Contour Next Gen Glucose Strips
Contour Next Gen glucose test strips are designed by Ascensia Diabetes Care for accurate blood sugar monitoring.
They work exclusively with Contour Next series meters and are known for:
- High accuracy backed by FDA approval
- No coding technology, making them easy to use
- Small blood sample requirements
- Fast readings within seconds
Many users report that these strips are preferred by doctors because they produce consistent results and are less likely to produce false readings compared to some generic alternatives.
How NaviCare Covers Diabetic Supplies
Under Medicare Part B and DME benefits, NaviCare covers medically necessary diabetic testing supplies prescribed by your doctor. This usually includes:
- Blood glucose monitors
- Glucose test strips
- Lancets and lancing devices
- Control solutions
However, coverage depends on whether the product is listed in the plan’s approved supplier list or formulary. Plans often have preferred brands, and if your strips are not on the list, you may need prior authorization.
Does NaviCare Cover Contour Next Gen Strips
Many members in Massachusetts find that Contour Next Gen strips are not always on NaviCare’s preferred coverage list. Instead, the plan may recommend other brands as standard coverage.
Coverage for Contour Next Gen strips usually depends on:
- Whether they appear in NaviCare’s DME supply list or pharmacy formulary
- If your doctor documents that you specifically need this brand for medical reasons
- If you purchase them from an in-network provider
A reliable method to confirm is to check the most recent formulary or call Member Services directly.
How to Confirm Your Coverage Step-by-Step
To make sure your Contour Next Gen strips are covered under NaviCare, follow these steps:
- Call NaviCare Member Services
Use the number on your member ID card. Ask if the strips are on your plan’s covered list. - Check the Formulary or DME List Online
Visit the NaviCare or Fallon Health website and search for diabetic testing supplies. - Speak with Your Primary Care Provider
They can request prior authorization if you have a medical need for Contour Next Gen. - Confirm the Pharmacy or Supplier is In-Network
Supplies bought from non-network providers may not be reimbursed.
What to Do If Contour Next Gen Strips Are Not Covered
Switching to a Covered Brand
Your doctor may suggest an alternative brand that is fully covered under your plan, such as OneTouch or Accu-Chek.
Requesting Prior Authorization
If you have been using Contour Next Gen strips successfully and switching could affect your diabetes management, ask your doctor to submit a medical necessity request.
Using Over-the-Counter (OTC) Allowances
Some NaviCare plans allow members to use quarterly OTC funds for eligible medical supplies, which may include certain test strips.
Paying Out-of-Pocket
If you choose to buy them yourself, prices range from $40–$80 for 100 strips. You can reduce this cost with pharmacy discount programs or manufacturer coupons.
Final Tips for Navigating NaviCare Coverage
- Always confirm coverage before purchasing diabetic supplies.
- Keep records of your prescriptions and past supply usage.
- If denied, ask your provider to submit a medical necessity letter.
- Compare out-of-pocket costs with alternative brands to find the best fit.
By taking these steps, you can ensure you have access to accurate glucose monitoring while minimizing costs.
FAQs
Does NaviCare cover Contour Next Gen glucose strips in Massachusetts?
Coverage is not guaranteed for all members. It depends on your plan’s approved supply list and whether your doctor provides medical necessity documentation. Always confirm with Member Services before buying.
Which glucose test strip brands are usually covered by NaviCare?
Many plans list brands like OneTouch and Accu-Chek as preferred options. However, coverage lists can change, so checking your plan’s most recent formulary is essential.
How do I request prior authorization for Contour Next Gen strips?
Ask your doctor to submit a prior authorization form along with a statement explaining why you need this specific brand. NaviCare will review and approve if criteria are met.
What is the cost of Contour Next Gen strips without insurance?
Retail prices typically range from $40 to $80 per 100 strips. Using manufacturer coupons, pharmacy discount cards, or buying in bulk online can reduce costs.
Can I use my OTC allowance to purchase glucose test strips?
Some NaviCare plans allow OTC funds to be used for certain diabetic supplies. Check your plan’s OTC catalog or ask Member Services if Contour Next Gen strips qualify.
