Does Medicare cover 670G and CGM yet?

Does Medicare cover the 670G? Does that automatically come with integrated CGM? Thanks. I’m in the USA.

Medicare will cover the 670G, but not the Guardian sensors. At least that is what Medtronic told me two weeks ago.

Medtronic has not impressed Medicare with it’s sensors. It’s a shame they got the Enlites and Sof Sensors approved (by the FDA), IMO.

Thanks. I guess I’ll have to use the Libre.

Mine doesn’t cover Libre either. You pay for the sensor. Nancy50

Medicare does NOT cover the 670g according to the local medtronics rep. and according to Byram Healthcare. I just switched from Omnipod to Medtronics in order to get better coverage under Medicare and was advised by multiple sources that the 630g was the best Medtronics pump to be covered. Their CGM is not covered so I use the Dexcom G5 which is covered. The Dexcom G6 is NOT covered.

CMS / Medicare has already issued the rules under which a cgm may be covered. It is up to the cgm manufacturer to meet those requirements.

A major component of the rule is FDA approval of non-adjunctive.

The Dexcom G6 will be covered as it meets all the standards for CMS. At this point, it is a matter of contracts and pricing.

1 Like

Medicare covered my 670g last year, but not my Guardian 3 CGM and sensors. I just reordered the sensors at a discounted cash price of $346 for a box of five from Medtronic. (CCS Medical wanted to charge me $450). I normally get about 12 days from each sensor; however, I got 18 days out of my last sensor.

Okay it’s now almost May of 2019. Does medicare cover the integration of the 670G and dexcom CGM?

USA users only.

670G and dexcom are not intergrated, but could be used independently.

Dexcom G5 is currently approved by medicare and can be ordered.

Dexcom G6 is approved, but due to supply limitations, Dexcom is delaying G6 for Medicare until later this year.

Medicare doesn’t like Medtronic sensors, so no coverage. :slight_smile:

http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle_Print&ID=2404422

New info on coverage of the Guardian 3 Sensors.

We have submitted an appeal to Medicare and our secondary insurance company.

1 Like

Fingers crossed👍

1 Like

Strength in numbers. Keep those appeals rolling in!!!

I think your link is for submission of FDA approval. Have you heard if actually approved yet?

They submitted the information just recently. Best guess to get the sensors shipping out to Medicare patients would be minimum 6-9 months. I’d be surprised at 9 months.

IF they get approved.

As I have stated before we have appealed for the G3’s and expect to hear from our private insurance company in 30 days and Medicare in 60 days.

I feel pretty sure the insurance company will have us do a second appeal, deny that and then go before a panel as they had us do with the Medtronic 670G insulin pump. That is an interesting story. Took nine months but the appeal was finally approved. November 2018 we received our M cgm.

We shall see what cards Medicare will play. I have heard people who have been successful with Medicare.

Fast forward to the G3 Sensors. Our private insurance company (same one) covered the G3 Sensors initially. But January 1 my husband went on Medicare so, as I have previously stated, no coverage for the G3 Sensors.

But wait, we have our same secondary insurance that has covered them just last year. And SAID they would continue to cover the Sensors. Now since Medicare won’t cover them, they won’t.

I know some of this is redundant.

So the saga continues.

We have done all we can. Gone through the proper channels as we wait for the dots to be connected.

One last thing.

Got our bill from Medtronic for 1800. plus. What they charge the insurance company for 3 boxes of Sensors. Cash price is 345. per box.

The billing people at Medtronic told me that I had to pay the 1800. since EVERYONE knows the G3 Sensors are not covered by Medicare. More to that story.

So wrong.

I don’t see any reason why they wouldn’t get approved. @DrBB has stated multiple times in countless posts that the G3 sensor’s accuracy is on par with Dexcom’s G5. I have complete trust in what he says. With Tandem’s loop system coming out shortly, I wouldn’t be surprised if more Medtronic users jump ship and move to Tandem instead of waiting for Medtronic’s approval to go through.

1 Like

@Jason99

Completely agree with all of that.

1 Like

This is the kind of thing that really drives me nuts. If they aren’t going to cover it, they aren’t going to cover it, but can’t they at LEAST provide accurate information so you can try to plan and be prepared? Just so frustrating because if you call them and they tell you something, you’re still left guessing whether it was true or not.

1 Like