Please be aware that Abbott’s FreeStyle Libre System, a glucose monitoring system for adults with diabetes, covered under the pharmacy benefit for commercial members in all states. To ensure appropriate utilization, prior authorization through Harvard Pilgrim’s Pharmacy Services Department is required. Please note that quantity limits apply.
The FreeStyle Libre system — which consists of two main components, a reader and sensor — is currently the only flash glucose monitoring product available in the United States. Capillary finger-prick blood glucose testing remains the mainstay of self-monitoring among those with diabetes. Appropriate use of the Freestyle Libre system should include device training and support. In addition, device readings should be shared and interpreted by a healthcare professional on a regular basis.
You can find the clinical criteria for the FreeStyle Libre System, as well as prior authorization request forms, on Harvard Pilgrim’s Medication Request Forms (MRF) and Clinical Coverage Criteria page.
Please note that all other covered diabetes management devices will continue to be managed by Harvard Pilgrim’s Medical Policy Department. For additional coverage and authorization information, please refer to the Diabetes Management Devices Medical Review Criteria and our Prior Authorization Policy.