I doubt Amazon will sell G7 sensors via Part B, all their info says “Pharmacy” which is a great way to buy them until you get on Medicare:
https://www.amazon.com/s?k=Dexcom+g7&i=amazon-pharmacy
Anyway, I’ve been using Edwards for Medicare Part B Dexcom supplies. Highly recommend, phone them and speak with a person who is knowledgeable about the details and set up an account. Everything has been smooth with Edwards so far.
1-888-344-3434
Will they fill at 76 days? I.e. the point at which Medicare Part B pays.
Not sure if I’ve tried that, give them a call. Seriously, they are one of the few vendors around with a knowledgeable and helpful person available on the phone.
I can tell you they are strict about the Medicare 6-month rule for clinical notes. No DME orders if you exceed 6 month max since your last dr. visit. I’ve been caught by that one once and now schedule my endo every 4 months to have a safety margin for rescheduling etc.
For those in the US on MediCare who can’t wait for the result of my own voyage of discovery when I try to get my G7 prescription filled by WalMart on Part B here is the relevant MediCare web site page:
(Thanks to @Terry4 for indirectly pointing that out.) Enter the zip code of your pharmacy (not your own) and search for:
“Blood Glucose Monitors and Supplies (Non-Mail Order)”
(It’s in the drop-down, right near the top because it is apparently a “popular” search item.) For me, in a low income unserved part of America, this shows seven local retailers, all pharmacies, that supply “blood glucose monitor supplies” (aka the G7 sensor). At least two of the listed pharmacies do, in fact, fill Dexcom prescriptions (WalGreens, before they took over RiteAid, and WalMart).
Suck it and see; since this is MediCare the pharmacist does not need your personal details “Medicare” is enough. I don’t know if a Part B supply provider is permitted to deny coverage. Service providers obviously are but are they if they do provide the same service to people not on Medicare?
John -
Thanks for the link!
Lists my local Walgreens as being able to supply my CGM needs.
We’ll see. ;-). But good to know.
PB
Medicare isn’t one thing, so please be careful when stating that Medicare does or doesn’t do something. I’m on Medicare and have been getting G7 sensors from a pharmacy (at the counter) since going on G7 a couple of years ago.
Obviously there are differences, probably depending on whether one is on traditional Medicare with supplemental plans, or an Advantage plan, and which one. I’m on an Advantage plan with a top-notch non-profit regional insurer.
Are we sure that they mean CGM where they say “blood glucose monitors”? And not just strips and meters? The tool returns 41 suppliers in the Tallahassee area. I’ve mostly obtained my G7s from Publix (regional supermarket) though once they had trouble with their distributor and I went to CVS.
Also to @Edward_Reid’s point, @jpob never said if they were on Medicare Part B or a MA plan.
Regardless, Walgreens as a company is falling apart, currently they can’t afford to pay enough staff to handle their current prescription volume, are refusing to fill certain arbitrary medications and won’t let their staff manually order medications that the automated system fails to fill. I consider CGMs right up there with insulin on the list of things I need to stay alive, there is no way Wags can be trusted with such an important prescription these days.
Yes. I verified this with my Part D insurer (Cigna, now taken over) and the G7 (specifically) is not covered under Part D. I just received my copy of “Medicare & You 2025” [the Oregon version] and it says that Medicare Part B covers “continuous glucose monitors” on page 38 in the middle under “Diabetes equipment, supplies and therapeutic shoes”.
There’s no ambiguity and, so far as I am aware, there never has been; on Medicare CGMs are Part B and, therefore, are covered for anyone who can afford to pay and pays for Part B. That section goes on to explain in detail that, “[S]ensors, transmitters, [sic] and receivers” are covered for CGM users. I don’t think there is anything suspicious about the spurious “,”; it seems completely unambiguous as written.
There is a condition to that whole paragraph in the first sentence of the next paragraph; verbatim but with my emphasis:
“You pay 20% of the Medicare-approved amount if your supplier accepts assignment.”
I think I can safely describe that as Medicare gibberish. What it seems to mean is that the supplier must agree to not charge us extra. I don’t yet know how much we pay for CGMs through Medicare but I’m guessing the amount is ginormous so no supplier in his or her right mind would not accept that payment.
My question, which you quoted, was not about coverage but about suppliers. Strips as well as CGMs are Part B. My question remains unanswered. (Not that I’ve done any additional research. 
) Remember that the acronym HBGM (home blood glucose monitoring) means strips, so “blood glucose monitors” is ambiguous.
You got half of it. It also means that the supplier bills the insurance, rather than charging you the full amount and requiring you to file a claim. IOW, it says that the supplier does what we expect all suppliers to do these days. It’s gibberish in the sense that it’s saying something that ought to always be true in the 21st century, though many of us remember when that wasn’t so common.
My plan apparently changed this year, as my most recent batch of G7 sensors had a zero copay. Last year, I was paying $190 for nine sensors, hence about $21 apiece. Since that’s a 20% copay, the pharmacy price was $105 per sensor. There might be pharmacies managing to charge more, but insurance companies won’t in-network pharmacies that rip them off.
At the end of the day the pharmacy avenue seems like a blind alley. I couldn’t find one that is prepared to supply under Part B and, regardless, the rules are always the Part B rules.
This is because Medicare Part B ends up paying, even with Part C (which is a privately administered Medicare A+B+usually D).
The B rule for refilling CGM supplies, a code of either A4238 or A4239, is:
The supply allowance (code A4238 or A4239) is a monthly allowance that may be billed to the DME MACs up to a maximum of three (3) units of service (UOS) and no more than a ninety (90) day supply may be dispensed to the beneficiary at a time. Refer to the CODING GUIDELINES section in the LCD-related Policy Article for additional billing instructions.
The Medicare rules further extend the restrictions on refilling CGM supplies. There are a lot of different restrictions and requirements. However it is Part B and there is neither a provision (that I can find) for early resupply or coverage outside the US for supplies under Part B.
Medicaid doesn’t help because it’s your primary insurer for Part D, not Part B; Medicare itself is you primary for Part B. Medigap (a private insurance companies insurance) does not help either because to be covered under any Medigap plan you first have to be covered under Medicare; the primary insurer. Yes, Medigap policies extend coverage outside the US but for emergencies.
So the answer to your question is the one @spdif provided at the end of his comment:
Ask your doc [for a prescription]. Pay the uninsured price. Consider part of the cost of the trip. You’ll only have to do it once or twice till you have enough spares.
You don’t need a medigap policy (“Plan F”; now I know who old @spdif is :-). You do need a prescription. Standard advice for US travelers abroad; carry a copy of all your prescriptions or, in this case better, carry an original prescription.
With that prescription you can go to a supplier in the foreign country and, if legal in that country, obtain the supplies. Well, sometimes you might have to see a local doctor too but generally pharmacists can prescribe. You will have to pay up-front but you might be able to reclaim on a Medigap policy. You might be surprised to find out how little it costs.
That applies for countries where your CGM is available (check first!) If not you can simply take a prescription to most US pharmacies and get it filled before the vacation; you don’t have insurance so you will have to pay the standard non-insurance price which is around $170 for a one month supply of G7 sensors (I don’t know for other sensors; check GoodRx).
Bear in mind that the Abbott CGM sensors are available without a prescription world-wide excluding the US and countries who think they are the US. The Abbott sensors work with 'phone apps so if you have a sort-of up-to-date mobile that is also a reasonable route.
https://diatribe.org/diabetes-technology/new-libre-sense-cgm-available-over-counter-europe
I’d have to laugh but I was crying.