Medicare DEXCOM CGM coverage

Recently switched to getting Dexcom supplies from a pharmacy because Dexcom did such a dismal job at supplying. Pharmacy is so much better but only receive a 30 supply even though on Medicare.

Dexcom recently switched me to Edgepark. They sent me a 90 day supply and a transmitter with my first order.
I have used Edgepark for my Medtronic pump supplies for a few years now.
They are fine, the first Dexcom order was a little slow.

Just want to update my original post. I talked with my doctor about my issue. She had her nurse call my supplier (Solar Medical Supplies). The nurse was told that Dexcom was starting a allow 90 day shipment of CGM supplies and that on my next order I would be able to order for a 90 day supply. When I called Solar to place a new order, I was told I was eligible for a 90 day supply. I placed the order and have received it. If any of you out there are still only getting a 30 day shipment, I would advise you to call your supplier and if that doesn’t work, ask your doctor for help.

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I have traditional medicare (part a and b) and my company sends 90 day supplies. ive researched this topic for a while and found a company that does 90 day orders and ships every 85 days. its a company’s choice to send 90 days vs 30 days, not medicare! these cheap companies just dont want to do it! im starting to build some extra days and the stress relief has been amazing!! how are you supposed to live worrying about a damn sensor failing and your next order doesnt come for a week or two. my new company is called wellstart medical they call me from 800-978-7599. there are others out there you just need to find them. god luck

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US Med will also send you a 90-day supply: 9 sensors and a transmitter for their Medicare folks. As I understand it, they actually bill Medicare every 30 days even though they send you a 90-day supply. However, US Med is NOT a Medicare-qualified supplier of Tandem pump supplies, should that be an issue for you. I believe that North Coast Medical out of San Diego will do this as well, but I have no personal experience with them as a supplier.

There are probably others that will do this.

Nothing is ever easy or obvious …

Stay safe!

John

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I tried to get a 90 day supply last month. Byram is my supplier and they do have that option, but Medicare would not approve a 90 day supply. I have to reorder every month.

There seems to be a lot of confusion between Dexcom, Medicare and the various suppliers. When I got my CGM it was directly from Dexcom. I was told that Medicare only allowed monthly shipments. When Dexcom got out of the shipping side of the business, I switched to Solara Medical Supplies. I was again told that Medicare wouldn’t approve 90 day shipments, so I still had to order each month from Solara. I talked to my doctor about the hassle of ordering each month. Her nurse contacted Solara and was told that Dexcom is now allowing 90 day shipments. No mention about any Medicare restrictions. The next time I contacted Solara I was told that my CGM sensors would be a 90 day shipment. I have since received this shipment. My advice to you would be to have your doctor contact your supplier and see what the problem is. Good luck.

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My understanding is Medicare still only covers 30 day supply. Some distributors are shipping 90 day, and billing Medicare every 30 days.

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they’re lying to you. medicare only pays 30 days at a time but a supplier can do 90 days if they want to. im on medicare and i get 90 day orders from wellstart medical. its honestly such a shame that someone blatently lies to you at a company. they know the rules and that they’re lying. they just hide behind it saying it’s medicares fault

it’s horrible that companies like byram and solara from the notes above that tell their employees to lie to people. all to make an extra buck i guess. ive been posting as much as i can about this becuase i was lied to too and told the same thing that i can only get a 30 day order while on medicare but decided to research and call and found companies that actually tell you the truth. getting 2-3 sensors at a time is horrible way to live!

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I am currently using Walgreens in my hometown for my g6 sensors and seem like I run into issues with them frequently. I’m still waiting for a refund because the clerk last November (2021) could not figure out how to run my BCBS supplement for the difference dispite the fact that they had done it for months prior correctly.
My current issue is pretty mind boggling. Both the sensor and transmitter Rx had expired and were renewed by the Dr. After a few weeks, the sensors were approved. The transmitter is stuck in Walgreens medicare back office black hole. Even the pharmacist can’t get them to move even after a three way call with me, medicare and the pharmacy tried to figure it out. Medicare says that if they approve the sensors, they approve all required accessories (transmitter, etc).
I went to Walgreens as Edgepark was an even worse nightmare. I ended up using the freestyle libre out of pocket as a backup on that one. Truly horrible.
Here is my question: who has had a great experience with Medicare, a supplement policy (not advantage plans) and with what medical supplier? There has got to be a better way than every 6 months or so going through some back office nightmare like I have been doing. Suggestions?

@Ncguy I have Medicare and BCBS “Gap” insurance. I get my Dexcom supplies through ADS (Northcoast Medical) They took care of setting up the approval and were pretty quick about it. They just text me it’s time for a refill, I click yes and 3 months worth gets shipped to me. 10 sensors and 1 transmitter. Dexcom actually falls under DME through Medicare. So you might try contacting ADS.

Since transmitters actually last to 112 days, you have a small overlap that eventually will net you an extra transmitter. Plus if a transmitter ever fails before the 90 days Dexcom replaces it, you actually gain some time there too. But early on Costco had a deal on transmitters and I got one so I could have a back up that I cycle through because the battery doesn’t have a long life. But through Costco if you are a member and in their pharmacy program (free) you can buy a transmitter for $149 with a script. You can also restart Dexcom sensors for now and build a nest egg for any issues that might come up.

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I use traditional Medicare with a supplement policy. I get 90 days of Dexcom supplies (9 G6 sensors + 1 transmitter) every 90 days like clockwork. They send an email, I respond, and they ship. The company is US Med, out of Florida. I pay zero out of pocket.

I keep up my end of the bargain by “seeing” my diabetes doctor regularly.

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I get most of my meds at local Walgreen but for some reason they they can’t or won’t do diabetic stuff so I use mail order vendors or another pharmacy.

i have used several mail order vendors and all had some problems. i had used Byram for a few years until they decided for some reason my insurance was not any good anymore even though it had not changed. I have traditional Medicare and secondary BCBS. BCBS recommended I find another vendor so i switched to Better Living Now. I had a lot of problems initially with them but since Medicare started paying for Dexcom stuff and BCBS pays for my OmniPods things have got much better. They will only send out 30 day supply for Medicare billing and you have to do the annoying phone call before each order and their billing is always behind, But they have been good about sending out the orders and I have never run out of supplies. I can place orders on their web site and they call me for the Medicare questions when needed.