Highmark will offer a new Diabetes Prevention Program in January 2018 for our Commercial product members who follow the standard Highmark Preventive Schedule. Self-funded employer groups may also choose to cover the program.
Highmark's Diabetes Prevention Program can help people with prediabetes prevent or delay the onset of type 2 diabetes. Members and their adult (18 or older) dependents who are at risk of developing type 2 diabetes may qualify for the program.
As a Highmark network provider, you can encourage your eligible patients to participate in this program. The program is covered at 100 percent for members who meet the criteria. Please use NaviNet® or the appropriate HIPAA electronic transactions to verify a member's eligibility for the Diabetes Prevention Program.
Highmark's 12-month Diabetes Prevention Program helps members who have prediabetes learn the skills to improve food choices, be more physically active, manage stress, and lose weight. Prediabetes can often be reversed through weight loss, healthy diet changes, stress reduction, and increased physical activity.
Highmark is working with the YMCA and RetrofitSM to offer members a choice of two convenient ways to participate in our Diabetes Prevention Program in the hopes that it will positively change their lives. Both program tracks are comprehensive, approved by the Centers for Disease Control and Prevention (CDC), and available at no cost to members, if they meet the criteria.
The benefit is limited to one program enrollment per calendar year. Two program options will be available:
The program includes:
If a member is interested in learning more about the program, he or she can review the program's options and requirements by visiting their Highmark member website and selecting the Diabetes Prevention link. The member is then taken to the Diabetes Prevention Program page where he or she can learn more about prediabetes, risk factors, and the two available program options. Once the member selects a program link, they then complete a risk assessment — the CDC Prediabetes Screening Test 
— to determine whether they qualify for the program. If they qualify, they will be given further instructions on how to enroll.
