I have been operating under the belief that Medicare part B will cover either cgm sensors or Bg test strips but not both. I use Dexcom G7 which Medicare covers and I purchase my test strips out of pocket.
Reviewing my new copy of Medicare and you - 2026 I found the following on page 38:
“If you’re using a continuous glucose monitor, Medicare will cover sensors, transmitters, test strips, and lancets.”
Am I missing something here or does this look like a policy change? Hopefully we
can now get coverage for both test strips and cgm sensors under Medicare part B DME.
I typically do a finger stick at least once a day to make sure the G7 is working okay and I always do a second finger stick before entering a calibration. When I start a new G7 session I may do lots (5 or more) finger stick tests in a day. As far as I am concerned Bg test strips are a part of the necessary process of Bg control.
I agree. I’ve been using CGMs for about 16 years now and I feel much safer when I can do a confirmatory finger stick. It’s especially needed if I’m going to take action, like a correction insulin dose to bring down a high or eating some carbs to stay out of a hypo.
I’ve been paying out of pocket for my test strips for years because Medicare vendors wouldn’t cover test strips if you use a CGM. I always thought that was unfair. I hope your reading of a regulation change is in fact true.
TL;DR version is you can usually get BGM supplies paid for through part d because the part d and part b computers aren’t checking each other. Yet. The consensus is that you can’t get both CGMs and BGM supplies paid for through part B and even if you could you don’t want to.
Medicare covers both my CGM and blood glucose test strips and lancets. I’ve utilized Medicare coverage of both CGM and test strips for nearly ten years.
Just for clarification on my original posting I have basic Medicare with a supplemental policy (Medigap plan G) from a big name insurance company. I get all my supplies (pump stuff, cgm and insulin) from a medicare dme service (ADS) that bills Medicare and the supplemental policy insurance directly.
cannot afford supplemental policy, receive only Medicare. Test strips may be covered however Medicare LIMITS the number of strips with Rx. Therefore at times when frequent testing needed have been spending a LOT on strips from retailers. Tried CGM and too many complications. Anyone know of low cost options for testing ? Using MEDTRONIC pump…… no CGM. thanks
Terry–
I have an MA plan. My claims for insulin and test strips are submitted to Medicare first, then to my MA plan. Medicare pays the majority of the cost for these items and my MA plan pays a few cents on them. I have no idea why these particular claims are processed in this manner/sequence, while other claims are submitted only to my MA plan. Claims for my CGMs are processed solely by my MA plan..
Bob–
I hope that Medicare covers the strips for you. It definitely helps!
Interestingly, my claims for test strips and insulin (I use an insulin pump) are submitted to Medicare first, then to my advantage plan for payment. Claims for my cgms are submitted only to my advantage plan. The intricacies of Medicare are mind-boggling. But, it works, so that is beneficial to me and all others with this disease.
I think there was a time when cgm users could not get Medicare coverage for test strips in certain states and territories, per an LCD from Medicare. That meant that Medicare coverage for test strips varied from state to state. Interesting and confusing. That LCD may have been the source of the folklore and mythology! I hope that LCD has been eliminated or has expired and all appropriate Medicare enrollees have access to coverage for test strips.
Awesome! Good luck and please let us know how it goes. I’ve been hoping someone with Medicare Part B would try to get strips from their CGM supplier. Did you check ADS to see if they sell the test strips your meter uses? Don’t be surprised if they try to claim the strips aren’t covered, the company makes less when you get strips with your CGM order.
My CDE tried this year and my pharmacy refused it. Now that she told me to be doing more fingersticks it would be nice. I am paying for 75 strips at around $30 out of pocket.
The excuse is Medicare doesn’t pay them any more for supplying test strips with the CGM than if they just supplied the CGM. You can order three G7s or three G7s with test strips, lancets and control solution, either way Medicare Part B is only paying ADS $267.92.
I’m currently using ADS for CGMs, the phone reps have to stick pretty close to a script, ask them to message their manager for help if they give you trouble. I’m hoping it’ll all go smoothly and you won’t need to know any of this.
No change, same in the “Medicare & You 2025”, same page. Here’s the verbatim quote:
Medicare covers meters and continuous glucose monitors used to estimate your blood glucose (blood sugar level), and related supplies including test strips, lancets, lancet holders, sensors and control solutions.
You get them from your Part B supplier and the Part B supplier must “accept assignment”. So you get them from the guys who supply the CGM. I’m using Edwards Health Care Systems and I have not requested test strip supplies yet because I don’t need them. I suspect I will just get some junk test strips that they make money from, but we shall see. I don’t use many test strips these days
I guess what they did in 2026 was clarify the wording; the 2025 wording was the union of supplies for both meters and CGMs. They apparently dropped “control solutions” but is that in there any more for meters?
Slightly off topic: I haven’t got my 2026 yet, are you talking about the mailed version or something online? (I find the printed version much more accessible than web pages.)
Yeah. I just checked on the Edwards web site because I’m running low and it was immediately obvious that I needed to talk to someone.
Thanks for the info. I hadn’t realized that I needed to combo everything up; ridiculous because my test strip usage is highly variable. Now I wonder if I get combo some ketone test strips in there too; important if the CGM reads over 250mg/dL!
I had a problem for years trying to get them covered while using a cgm. I needed riteaid to put them as adjunctive to CGM. They finally went through the pharmacy on part B. At first the pharmacy told me there was no place to put that on the form, they must of called with the right words. I hope this helps because I understand the frustration you feel.
I only went on to Medicare recently (April) and I’m on “original” too. I was unable to get any of the pharmacies I tried to fill a CGM prescription on Part B. IRC I did try RiteAid and they said, “Oh yes, no problem, Part B” and were far more sensible but then they rang up and said they couldn’t do CGMs on Part B; not the test strip, the whole CGM which, on “original” is only available on Part B!
It took me awhile to finally get it straightened out. I talked to the pharmacist and told him itneeded to be ran has “test strips adjunctive to CGM” Itis not eas for them because there is no t a clear spot on the form to put it. But there is a way maybe a phone call by themto medicare? Once they finally got it correct everything has been good even with them closing in my state and transferring my scripts to Walgreens.
