Insurance coverage of CGM

These days if you cannot get a new pump that was approved with an integrated CMG system, do most health insurance companies cover CGM system and supplies? I

I have seen reports indicating some 95% of health insurance plans provide some sort of CGM coverage, but you will have to check with your insurer. Perhaps even easier, check with the CGM manufacturer - they typically deal with coverage issues every day and should be able to advise you very accurately on what your insurance will cover.

There may be some extra paperwork involved. In my case (BC-BS of Mass) my endo had to certify a certain number of hypo episodes in the past month to establish the need. But it was pretty trivial.

Medicare is the one major US insurers who do not routinely approve CGM’s. Most approve it fairly routinely these days now coverage amounts might be a different story.


Is it harder to get coverage with Kaiser? Blue Shield of CA has covered it for me.

My doctor also had to provide info on lows–that was the key criterion, with little or no consideration for high A1c. “Luckily”, I am susceptible to exercise lows so that wasn’t a problem. Weird, eh?

Thanks everyone for the information. It was very helpful.