Does Medicare cover Continuous Glucose Monitors (CGM)?
If you have diabetes and are on Medicare, you might have questions like "does medicare cover continuous glucose monitors (CGM)?" Good news: certain CGM devices are covered, provided that you meet the necessary requirements. To learn what the qualifications are, and other pertinent information, read on.
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UPDATED: Mar 17, 2021
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- The short answer is “yes, to those who qualify.”
- Patients will need to meet certain criteria to be covered for a CGM.
- Only certain brands meet the requirements.
Those who have been diagnosed with diabetes are likely to be familiar with continuous glucose monitors or CGM devices. What CGM devices do is track the patient’s blood sugar levels by collecting readings every few minutes. This helps doctors to determine trends that will help manage diabetes.
Does medicare cover continuous glucose monitors (CGM)? The good news is that Medicare can indeed provide coverage, provided that the patient meets the proper criteria.
Medicare is generally only available for people over 65 years of age. For those that do not qualify, it might be important to know how to buy health insurance that fits you.
If you are looking for affordable health insurance, you can enter your ZIP code into the box above for cheap health insurance quotes in your area. It can also be used for any other insurance needs you may have.
What is needed to qualify for CGM coverage under Medicare?
There are a few criteria necessary to receive coverage for a Continuous Glucose Monitor under Medicare:
- The patient must have been diagnosed with type 1 or type 2 diabetes.
- The patient currently uses a blood glucose monitor (BGM) and performs BGM testing at least four times a day.
- The patient is treated with multiple daily injections of insulin or uses a continuous subcutaneous insulin infusion (CSII) pump.
- The patient’s insulin treatment regimen requires frequent adjustments.
- Six months before ordering the CGM, the patient had an in-person visit with their doctor to evaluate diabetes control and make sure the above criteria has been met.
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What brand of glucose meter is covered by Medicare?
There are several options for CGM devices that are covered by medicare. In addition, there are other diabetes supplies that are covered through Medicare, either partially or fully. As this can change from year to year, it’s worth checking out the Medicare website for questions about coverage.
You can also check out Medicare’s Coverage of Diabetes Supplies, Services & Prevention Programs. Not only does it have information about what Medicare covers, but also lets you know where you can find more information so you can make the best decisions regarding your health.
Who is eligible for Medicare?
All of the above is contingent on if you actually qualify for Medicare. As mentioned before, Medicare is generally only offered to people over 65. However, it is available to younger people with disabilities, and people with End State Renal Disease, which requires dialysis or a kidney transplant.
If you are not eligible for Medicare, there are other options to choose health insurance. For starters, you can take a look at our best insurance companies. This provides information not only on health insurance, but also on many others including auto, home, life, and even pet insurance.
Insurance can sometimes be a confusing, daunting prospect, so we also recommend checking out our insurance terms. There are many terms that will help you make sense of health (and other) insurance. Finding the insurance the fits you best is important.
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