I stopped using Libre2 cgm because it was inaccurate now Medicare won’t cover glucose test strips for five years

Last week my Safeway pharmacy representative told me they would not pay for my glucose test strips even though my physician has prescribed them. Last year I started using the Libre2 cgm but by April 2023 I was having too many issues with sensor failures and inconsistency with glucose readings and accuracy. At first I appreciated not having to test my glucose with finger sticks 6 or more times per day but when it became evident that the Libre2 readings were sometimes inaccurate by as much as 25 percent and my A1C was increasing I stopped using it and did not refill any prescriptions. I called Medicare and was told that the “same or similar” clause for covered equipment prohibits changing equipment because the useful lifetime of this equipment is five years. I am appealing this decision. Has anyone else had this issue with Medicare? and had any success overturning this incredibly stupid rule? Anyone who sticks their fingers constantly can attest that this is not something anyone would do willingly. But using Inaccurate cgms isn’t an option when your life depends on accurate insulin dosing based on glucose readings. So for the time being I am purchasing the 200 test strips I require monthly.
Thank you for any information you can share with me. If my physician had informed me last year of this bizarre Medicare rule I would not have started using the Libre2.

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Maybe you could switch to dexcom or Medtronic sensors.

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If it was prescribed as DME, then MC treats the meter as “durable”, and should last 4 years, similar to pump purchase. Some plans may treat it as pharmacy benefit.

Check if your doctor can provide documentation of the accuracy, and possibly prescribe an alternative.

Assume you wash hands or use alcohol wipes to see if the accuracy improves.

i personally stopped using libre2 due to its inaccuracy, however, you do have the jugglucco app and xdrip app that you could try, at least with xdrip you can calibrate, and it might help…i assume you are only calibrating during the normal no recent meals, insulin, exercise, how ever, you could also look into diathrive as a last or 3rd option, as it seems to be at least one of the cheaper 200 per month test strip options out there…a .4 microliter, $10 meter, $32/month for 200 test strips, one other alternative is to try and figure out if you have any contraindications with other medicines…i personally found cgms, especially the libre, to give false readings with ibuprofen, antibiotics, some high blood pressure meds, vitamin c, aspirin, and often switching to alternatives will help…

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I don’t really know, but a possible idea.

Medicare will not cover a CGM and test strips at the same time. Plus like with a pump they don’t want to pay for pumps/readers etc more than every 4/5 years because of the cost factor.

Just an idea, but if you are not requiring a new meter, just the strips, maybe make sure they know the CGM script is canceled and not current? They will not want to cover both if they think the CGM is the current script available. The argument would be instead of getting sensors, you will be getting strips. Not sure whether that will make a difference. And for some reason I think Medicare might only cover 100 strips a month max anyway? And someone already said is it possible to switch to Dexcom which you can calibrate? I wonder if that would be an issue too?

I still probably use 50 strips plus a month with my Dexcom that Medicare doesn’t pay for. I use a lot the first 2-3 days when I start a new sensor or restart one. And then I check the sensor accuracy off and on. Even with Calibration a new sensor especially, can be off a lot those first couple of days.

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Try the cheap out of pocket, over the counter, BG meter/strips at Walmart called ReliOn. They are so inexpensive that its not even worth pushing through insurance. Leaving all the Rx and insurance hassle behind is the best thing about it. Good riddance!

That ruling is insane. Medicare is insane.