Highmark introduces diabetes prevention program benefit for group customers eligible employees with the benefit can enroll beginning Jan. 1

PITTSBURGH, Pa. (Nov. 8, 2017) — Highmark Blue Cross Blue Shield announced today that it will cover a new diabetes prevention program as a preventive benefit for group customers. The structured lifestyle and health behavior change program, which is recognized by the Centers for Disease Control and endorsed by the Centers for Medicare and Medicaid Services (CMS), can help prevent Type 2 diabetes in employees who are identified as pre-diabetic.

"More than 29 million US adults have diabetes and 84 million US adults are living with prediabetes," said Lori Hough, vice president of Clinical Care and Wellness for Highmark. "Prediabetes is a serious health condition that increases a person's risk of developing Type 2 diabetes, but it is reversible, so it's important that we address it."

The new diabetes prevention benefit will consist of a 12-month life style behavior change program. Two program options are available — in person through a local YMCA (where available) or online/mobile through Retrofit, a leading provider of weight-management and disease-prevention programs. Both programs include structured sessions led by a trained Lifestyle Coach that includes food, weight and activity tracking, as well as group support. The YMCA's Diabetes Prevention Program option is for members who might prefer the in-person meetings and support of the coach and others who are on the journey together.

In West Virginia, access to YMCA Diabetes Prevention Programs are currently limited, but may be expanded in the near future.

For those without access to a local YMCA class or prefer to do the program through an online/mobile format, Retrofit offers a proprietary lifestyle-patterns assessment to drive personalization, one-on-one live sessions and unlimited messaging with an expert coach, expert-led online interactive lessons and missions to encourage learn-by-doing, social support and an app, online dashboard and self-monitoring tools for tracking weight, food, mood, steps and exercise.

The new benefit will available Jan. 1, 2018 to both fully insured and self-funded commercial groups that follow Highmark's standard Preventive Schedule. Highmark-covered employees ( and their covered dependents over the age of 18) of groups that offer the benefit will be able to link to either the YMCA or Retrofit websites through the Highmark member portal and take an assessment to see if they qualify after Jan. 1. The YMCA site includes a zip code finder to help members search for a local YMCA's Diabetes Prevention Program location.

The primary goal of the program is to help participants achieve at least 5 percent weight loss.

"Our estimates show that employers could see $400 to $1,300 per year in savings per member when a participating member reaches the 5 percent weight loss goal through the program," said Hough. "So not only does the employee and/or their family member benefit from being healthier and avoiding diabetes, but the employer benefits too. Plus, healthier employees benefit everyone — themselves, their families and their employer."