How to Reduce the Cost of Continuous Glucose Monitoring (CGM) with Insurance

Understanding CGM Coverage: Medicare and Private Insurance

Continuous Glucose Monitoring (CGM) devices provide real-time insights into blood sugar levels, helping patients manage diabetes more effectively. CGMs can support decision-making around insulin, diet, and lifestyle, contributing to better health outcomes.

Coverage for CGM devices depends on the plan. Medicare and many private insurance plans may provide coverage under certain conditions, which often include:

• Durable Medical Equipment (DME) benefits for eligible patients.
• Coverage for CGM devices for insulin-dependent individuals.
• Coverage for sensors, transmitters, and receivers.

Coverage may require documentation from your healthcare provider. Eligibility and benefits vary by plan and region.

Recent Policy Updates You Should Know

Medicare has expanded CGM coverage for some patients using insulin therapy. Private insurers’ coverage policies differ, including which CGM models are covered and how many sensors are reimbursed per month. Understanding your plan’s specific rules is important to avoid unexpected costs.

Understanding Out-of-Pocket Costs

Even with coverage, patients may have deductibles, co-pays, or supply limits. Newer CGM models with advanced features may also involve higher costs. Being aware of potential expenses helps patients plan and budget for their care.

How Insurance Solutions USA Can Assist

Insurance Solutions USA can help you understand your insurance options and coverage rules. Our team provides guidance on:

• Reviewing plan benefits and coverage requirements.
• Understanding potential out-of-pocket costs.
• Exploring supplemental insurance options that may offset expenses.
• Helping you compare CGM devices based on coverage and personal needs.

Take steps to understand your options and make informed decisions about CGM coverage.

For assistance, call us at 817-756-1442 or book an appointment onlinehere. Learn more atInsuranceSolutionsUSA.com.

Medicare beneficiaries: This information is for educational purposes and does not guarantee plan availability, coverage, or cost savings. Plans vary by region.