Medicare coverage of CGM New rules

Today CMS released a new set of proporsed rules dealing with CGM’s THe new rules if adopted means mediacre will begin covering all sensors and associated devices, except telephones wether or nto these devices require calibration. This is an especially important step for those who use medicare and have medtornic sensors and pumps. It is also potentially important for all future sensor technology and PWD’s regardless of device.

This is the statement from CMS:

and the statement form Medtronic

it is not a done deal as yet, but it appears to be coming. fingers crossed.

I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things. OK, they sent me a shirt and a cup but even I am more expensive than that.


Thanks for the update.

I called Medtronic regarding the uninsured discount program and was advised I qualify to buy 3 cartons of Guardian 3 sensors at $60per box. The transmitter would be $180, but I already have one.


1 Like

Not all Walgreens do. Medicare Coverage for Dexcom is under Part B, as DME, not your Part D Prescription plan. (For most MC).
Many/most pharmacies don’t have the systems or employees trained if there is no demand for Part B (dme) processing.

But Dexcom is working to get more Pharmacies up to speed, and more Employer plans to cover dexcom as a pharmacy benefit. Will take time, but going in the right direction.

Somewhere I saw it mentioned that if you don’t have local Walgreens that can process G6 for Part B Medicare, they should be able to identify nearby Walgreens to process and ship to you.
Can also get from mail order DME suppliers.

For non-Medicare, Dexcom is trying to get more employer plans to process as prescription, so they can be picked up locally. My plan switched to Pharmacy this year, and I get my Dexcom supplies at Costco.

1 Like

Yeah, Walgreens is working on it. I’m just filling Dexcom, for the first time, through a ‘typical’ walgreens (as opposed to a specialty one). I’m not medicare or an employer plan. It was a little rocky, but it looks like they will be able to do it. Pharmacy is generally believed to be the cheaper option.

Does this only apply to meal time insulin users? I am a type 2 ,take trulicity and tresiba . I have tremors in my hand. I have tried twice to get a cgm. No response. Nancy50

I had a letter from medtronic (a few years back) about free sensors - buy one get two free if you try them - they then billed me and hounded me for 14 months until they admitted their error - later they wanted me to prove such a letter existed - I still have it - If you think about it - it is impossible to prove they wrote and sent it even if you have a time machine. Medtronic is a creation of whatever devils exist. The first thing they will do if you take their offer (imho) is bill whatever insurance you may have had and then bill you the full price when the insurance denies it.

I placed the order and was advised that Medtronic will check with my insurance and if denied, will Bill me the $60/box. I will advise the final results; however, they have to First contact my doctor to renew my Prescription.