What is the difference between MyCare and Medicaid benefits?

	MyCare	Medicaid
Is Case Management available for my patient?	Yes	Yes
Is my patient automatically enrolled in Case Management?	Yes	No
Is CGM a covered benefit?	Yes	Yes
Is Prior Auth required for CGM?	Yes*	No
Is DSME a covered benefit?	Yes	Yes
Is Non-Emergency Transportation a covered benefit?	Yes	Yes
Is the pharmacy benefit managed by Single Pharmacy Benefit Manager (Gainwell)?	No	Yes
Is the pharmacy benefit managed by the health plan?	Yes	No

 

For Aetna, no prior authorization is required for providers in the Aetna network.

For CareSource, no prior authorization for Dexcom and FreeStyle through pharmacy benefit.

Access information for common CGM actions with MyCare patients >

Access information for common DSME actions with MyCare patients >