CGM Coverage with MediGap

I’ve been using Dexcom products since early 2018, and they are the only reason I’m still driving, and probably the only reason I’m alive, given my hypoglycemia-unawareness.

Now, after 63 years of MDI treatment, I’ve finally progressed to the point of starting hemo-dialysis within a month or two.

I’ve always used my Medicare Advantage coverage through Kaiser to make Dexcom use very affordable, but when I subscribe to MediGap coverage, Medicare Advantage plans are no linger an available option.

Can those using MediGap (Part G), please tell me under which Medicare program they are able to secure CGM benefits?

Thank you advance for any insight the group can offer!


I use traditional Medicare along with a supplement Plan G provided by the USAA insurance company. US Med supplies me with nine Dexcom G6 sensors plus one transmitter every 90 days. I pay zero out of pocket with this coverage.

This zero out of pocket coverage depends on your eligibility to secure coverage of a supplement plan. When you turn 65, there is a several month opportunity to sign up for both traditional Medicare and a supplemental plan without underwriting questions. Once that opportunity expires, I understand it is no longer available.

You can, however, go from Medicare Advantage to traditional Medicare. One of our members, @Laddie, knows a lot more than I do about this issue. Good luck!

Thank you, Terry. Just when I had finally become somewhat familiar with the various Medicare Parts, I’m going to get to change!

I’ll turn 65 a in a couple days, so I’m within the open enrollment period for Medigap.

USAA is who you use for prescriptions, right? I think the carrier I’ll be choosing for prescriptions is WellPoint.

Again, thank you for your thoughts!

1 Like

No, USAA provides my Plan G supplement coverage. I use a Cigna Part D prescription plan this year.

Glad to read you’re in the open enrollment period. I highly recommend choosing traditional Medicare with a supplement – a choice that is not fully restorable if you choose a MA plan now.

The unrestoreable part is the ability to qualify for supplement coverage sans the underwriting department becoming involved. The Part D plans are changeable every year.

I should point out that my Dexcom supplies are covered under Part B, not Part D, a critical distinction.

Thanks, Terry, Medicare confuses me, so thanks for confirming Dexcom is provided under Part B.

I think the Supplement I’ve narrow it down to is Regence.

I use Apidra and Tresiba, and I’ve chosen a Part B under which they are not covered, but I can get to Canada withing an hour, to buy insulin at an incredible discount.

If you delivered your insulin via a pump, your traditional Medicare with a Supplement would cover the insulin 100% with zero out of pocket cost.

Is that true for Omnipod 5? I am shopping for Medicare Part D plans and this issue confuses the process.

Medicare Part B covers 80% of your Dexcom cost. You need a supplement plan if you want 100% coverage. The Dexcom 20% balance for me is covered by my supplemental Medex plan which covers me for all sorts of other stuff internationally which would not be covered through Medicare.

Sorry, John. Omnipod is not covered by traditional Medicare Part B. It is covered by certain other plans but I’m not knowledgeable about which ones.

Omnipod got approval for Medicare via pharmacy Part D and not the traditional coverage for insulin pumps as DME in part B. Under my “regular insurance” before Medicare it was DME, but under Medicare it’s a prescription under your optional part D pharmacy plan.