Insurance Prior Auth Checklist

Getting your diabetes supplies covered by insurance doesn’t have to be complicated. Our comprehensive insurance prior auth checklist makes the process easier to understand and manage. Whether you’re seeking coverage for a CGM system or other diabetes supplies, this guide will help you gather everything you need.

Understanding Insurance Prior Authorization

Prior authorization (often called ‘prior auth’) is when your insurance company needs to approve a medical device or medication before they’ll cover it. Think of it like getting permission before making a big purchase.

Your Insurance Prior Auth Checklist

Download and print this checklist to keep track of each step:

1. Basic Information Required:
   • Your full name and date of birth
   • Insurance ID number
   • Medicare number (if applicable)
   • Your doctor’s name and contact information
   • Your pharmacy information
2. Medical Documentation:
   • Recent A1C test results (within last 6 months)
   • Blood glucose testing records
   • Current diabetes medication list
   • History of diabetes diagnosis
3. Doctor’s Documentation:
   • Letter of medical necessity
   • Prescription for requested supplies
   • Clinical notes from recent visits
   • Documentation of failed alternatives (if applicable)

Medicare-Specific Requirements

• Diabetes diagnosis (Type 1 or Type 2)
• Testing blood sugar 4+ times daily
• Insulin treatment with multiple daily injections or pump
• Regular diabetes management visits with your doctor

Common Prior Authorization Challenges

Here are typical hurdles seniors face and how to overcome them:

• Missing documentation: Keep a complete file ready
• Expired test results: Schedule regular A1C tests
• Incomplete forms: Use our checklist to verify everything
• Delayed responses: Follow up weekly

Next Steps After Submission

1. Mark your calendar for 5-7 business days after submission
2. Call your insurance if you haven’t heard back
3. Keep a log of all communication (who, when, what was said)
4. Ask for specific reasons if denied

Need help with your prior authorization? Call us at 888-649-5705, and our friendly team will guide you through the process.

Last updated: January 2025