Colorado Option Plans

Elevate Health Plans Colorado Option plans provide coverage of diabetic supplies at $0 cost-sharing. That means these diabetic supplies are not subject to deductible, copayments or coinsurance, even if you haven’t yet met your deductible. 

Covered Diabetic Supplies

All diabetic supplies below are covered at $0 cost-sharing under your Colorado Option plan Pharmacy Benefits.

DEXCOM G6 RECEIVER*
DEXCOM G6 SENSOR DEVICE*
DEXCOM G6 TRANSMITTER DEVICE*
DEXCOM G7 RECEIVER*, **
DEXCOM G7 SENSOR DEVICE*, **
EVERSENSE 365 SENSOR SUBCUTANEOUS DEVICE*, ** 
EVERSENSE 365 TRANSMITTER DEVICE*, ** 
FREESTYLE LIBRE 14 DAY READER*, ** 
FREESTYLE LIBRE 14 DAY SENSOR KIT*, ** 
FREESTYLE LIBRE 2 PLUS SENSOR DEVICE*, **
FREESTYLE LIBRE 2 READER*, **
FREESTYLE LIBRE 2 SENSOR KIT*, **
FREESTYLE LIBRE 3 PLUS SENSOR DEVICE*, **
FREESTYLE LIBRE 3 READER*, **
FREESTYLE LIBRE 3 SENSOR DEVICE*, **
GUARDIAN 4 GLUCOSE SENSOR DEVICE*, **
GUARDIAN 4 TRANSMITTER DEVICE*, **
GUARDIAN CONNECT TRANSMITTER DEVICE*, **
GUARDIAN LINK 3 TRANSMITTER DEVICE*, **
GUARDIAN SENSOR 3 DEVICE*, **
SIMPLERA SENSOR DEVICE*, **
SIMPLERA SYNC SENSOR DEVICE*, **

*Prior Authorization is Required
** Effective 1/1/2026

ILET INSULIN PUMP*,**
ILET INFUSION KIT-INSET 23" COMBO PACK**
ILET INFUSION KIT-INSET 32" COMBO PACK**
ILET INFUSION-CONTACT DTCH 23" COMBO PACK**
ILET STARTER KIT CONTACT KIT**
ILET STARTER KIT-INSET KIT**
CEQUR SIMPLICITY DEVICE 2 UNIT**
CEQUR SIMPLICITY INSERTER**
MINIMED 630G INSULIN PUMP*,**
MINIMED 780G INSULIN PUMP*,**
OMNIPOD 5 (G6/LIBRE 2 PLUS) SUBCUTANEOUS CARTRIDGE**
OMNIPOD 5 G6-G7 INTRO KT (GEN5) SUBCUTANEOUS CARTRIDGE**
OMNIPOD 5 G6-G7 PODS (GEN 5) SUBCUTANEOUS CARTRIDGE**
OMNIPOD 5 INTRO(G6/LIBRE2PLUS) SUBCUTANEOUS CARTRIDGE**
OMNIPOD DASH INTRO KIT (GEN 4) SUBCUTANEOUS CARTRIDGE**
OMNIPOD DASH PDM KIT (GEN 4)**
OMNIPOD DASH PODS (GEN 4) SUBCUTANEOUS CARTRIDGE**
T:SLIM X2 CONTROL-IQ*,**
TANDEM MOBI AUTOSOFT 30 KT 23" COMBO PACK**
TANDEM MOBI AUTOSOFT XC KIT 5" COMBO PACK**
TANDEM MOBI AUTOSOFT XC KT 23" COMBO PACK**
TANDEM MOBI AUTOSOFT30 14PK 23 COMBO PACK**
TANDEM MOBI AUTOSOFTXC 14PK 23 COMBO PACK**
TANDEM MOBI AUTOSOFTXC 14PK 5" COMBO PACK**
TANDEM MOBI SYSTEM*,**
TANDEM MOBI TRUSTEEL KIT 23" COMBO PACK**
TANDEM T:SLIM ASFT 30 PK10 23" COMBO PACK**
TANDEM T:SLIM ASFT 30 PK14 23" COMBO PACK**
TANDEM T:SLIM ASFT XC PK10 23" COMBO PACK**
TANDEM T:SLIM ASFT XC PK14 23" COMBO PACK**
TANDEM T:SLIM TRUSTL PK10 23" COMBO PACK**
V-GO 20 DEVICE**
V-GO 30 DEVICE**
V-GO 40 DEVICE**

*Prior Authorization is Required
** Effective 1/1/2026
 

Freestyle Freedom Lite Kit
Freestyle Insulinx
Freestyle Lite Meter Kit
Freestyle Precision Neo Meter
Freestyle System Kit
Precision Xtra Monitor
Freestyle Insulinx Strips
Freestyle Insulinx Test Strips
Freestyle Lite Strips
Freestyle Precision Neo Strips
Freestyle Test Strips
Freestyle Xtra Test Strips

Effective 1/1/2026 - Please see "Blood Sugar Diagnostics" category in the prescription drug list (formulary) for a complete list of covered Test Strips.

Freestyle Lancets 28 Gauge
Freestyle Unistik 2

Effective 1/1/2026 - Please see prescription drug list (formulary) for complete list of covered Lancets, Syringes and Needles.

 INPENS**

Effective 1/1/2026 - Please see prescription drug list (formulary) for complete list of covered Inpens.

** Effective 1/1/2026

Frequently Asked Questions

  • To learn more about a product on this list, check your prescription drug list (formulary) for tier information, coverage rules, and any limits (such as quantity limits).
  • To find an in-network pharmacy, check the pharmacy directory by signing in to your MedImpact member portal. MedImpact is our pharmacy service provider.
  • Have your pharmacy submit a claim to MedImpact to process the claim under your pharmacy benefit.

If you have more questions about your pharmacy benefits, please contact us by calling 303-602-2070. 

If your plan requires pharmacy prior authorization for a diabetic supply, your healthcare provider (doctor, nurse practitioner, etc.) will give us information about your diagnosis, treatment history and other relevant information to request pharmacy prior authorization. If the pharmacy prior authorization request is approved, you will pay a $0 cost share, not subject to a deductible.

Patients: 
Your doctor will need to submit a pharmacy prior authorization request. 

Providers: 
For more about pharmacy benefits, please contact MedImpact by calling 1-800-788-2949, faxing 1-858-790-6022 (preferred method) or submit an online pharmacy prior authorization request.