Medicare Now Covers Dexcom G5

This is very exciting news!!! I will call my MVP insurance today. It is affiliated with Medicare, and follows Medicare rules. I should get coverage for the Dexcom G5 very soon. :slight_smile:

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I think that more information is expected on April 15 and hopefully then more suppliers than Liberty will be able to supply Dex G5 to Medicare people. I’ve gone as far as setting up an account with Liberty but am hoping to simplify my life by waiting until CCS can supply me.

Has anyone on traditional Medicare gotten G5 from a supplier other than Liberty yet?

Thanks for sharing the info, Richard.

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I read online that ADW Diabetic Supplies located in Pompano Beach, FL is now selling the Dex G5. I don’t know much about them, although I saw that they received 5 stars on a BBB review. Their web site is currently down for maintenance so I couldn’t check online for any pricing.

BTW; Laddie, have you ever heard from Sue in Harrisburg, PA lately? I knew that her husband was fighting Medicare to get a CGM before Medicare approved these devices. Although, he was finally able to get a CGM through the VA since he is a Veteran, and so they stopped their fight against Medicare. As you know Sue is a super advocate for diabetes who got me connected with a great lawyer in our area to help us with our fight against Medicare for the OmniPod Pods only to lose our fight with CMS after a year of trying. My wife is still waiting for Liberty Medical to get back to us on the Dex G5 she applied for going on two weeks ago.

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Great news! I can hardly believe it.

I still occasionally talk with Sue and her husband continues to do great with the VA as his pump and CGM supplier. I certainly appreciate everything she did in advocating for Medicare coverage of CGM’s.

The non-coverage of the Omnipod by Medicare makes no sense, but I think it would be close to impossible to win an appeal unless it was based on coding issues. Medically I don’t see how one could argue that the Omnipod does anything different than other pumps. A couple of my friends who are on Advantage plan get Omnipod coverage. Hopefully this will change soon.

Laddie,

Thanks for the update, I’m glad to hear Sue and her husband are doing OK!

FYI: I have been in contact with Insulet Management in particular the VP of Market Access, both he and Insulet’s CEO Mr. Sullivan were in DC last month working with Medicare in lobbying to get the OmniPod Pods approved since the Dex G5 CGM was approved. He informed me they were very close in December in getting this done prior to the Administration change from President Obama to President Trump, but Medicare management decided to hold off their decision until the new Regime takes over at CMS under Administrator Seema Verma.

Insulet (Omnipod) Management would greatly appreciate the Senior users of the OmniPod on Medicare personally emailing their Senators and Congress person to help in getting the OmniPods approved. Also, if you would like to sign a petition I have another link that needs 300 signatures to possibly get some action by setting the wheels in motion.

Thanks!