Covid changes to medicare cgm

Type 2
1

has anyone heard anything about medicare covering cgm during the covid pandemic? right now i am on a cgm but my sister in law who is also on medicare did not qualify but recieved news that she may now because of some change? curious if anyone else heard similar news?

2

Founds this -
During the COVID-19 Public Health Emergency, the Centers for Medicare and Medicaid Services (CMS) has modified Medicare payment and coverage rules to allow for healthcare providers to offer Diabetes Self-Management Training services to Medicare beneficiaries through telehealth. These services are available over video access, or audio-only methods for beneficiaries who do not have access to internet or other technologies that allow for visual-included interactions. Beneficiaries who have continuous glucose monitors (CGMs), no longer need to meet their physician face to face for CGM, testing supplies and refills in order to maintain coverage. Additionally, CMS will not enforce Medicare’s coverage policy’s clinical indication requirements, including the requirement that beneficiaries must perform SMBG 4 or more times a day. During the COVID-19 Public Health Emergency, the American Diabetes Association continues to work with the administration to ensure individuals with diabetes aren’t faced with gaps in health insurance coverage should they become unemployed, as well as zero dollar copays for insulin, and increased access to COVID-19 testing.

Nancy50

1 Like
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Does she take meal time insulin? That is your so called ticket in. Nancy50

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I am on medicare and have had no issues during Covid receiving my Dexcom supplies and having medicare cover the expense in the same manner as before Covid

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Thanks i was asking about people that didnt qualify before covid but now all of sudden qualify for cgm

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yes she takes insulin once per day. that’s all you need?

7

I just tried to get it approved. I take trulicity and Tresiba and since this is not meal time insulin I did not qualify.
The changes are doctor visits and paperwork. It is my understanding if she is a vet,might be different. I am told
( companies) they are working to get it approved for type 2 “. That is what I was told,just 2 days ago. Very frustrating!

Nancy Matulis

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CJ are you on mealtime insulin or a type 1.? Then you have no problem. Nancy50

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I understand what you are asking, but I was told, no I did not qualify. I test 5-6 times a day, exercise, monitoring closely. But no short acting insulin. Nancy50

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Insulin ,there are several types of insulin and noninsulin injectables.
Basal is a long acting insulin taken once a day, like Tresiba. There are other injectables taken around a meal, short acting insulin. Look up the insulin to see how it works. Nancy50

11

I am on fast acting Humalog only. I gave up Lantus and Levemir basal insulins as they were the cause of all my night time lows. In 30+ years, they have not yet been able to properly type me at Joslin as I don’t fit the standards for any of the types they have on file except for MODY and I have tested negative for MODY.

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Very interesting CJ114, I hope it continues to work for you. Joslin is the best. Nancy50

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I am a type-1B, a strange variation of type-1. Type-1B is an idiopathic type-1, and has to be treated as any type-1.

There have been times my pancreases is effectively shut down, and time when its on a severe work slowdown. I also have Multiple Sclerosis, with some/minor effect, and Addison’s that for a while made my diabetes “brittle”. until I got my Addison’s in good control.

JD