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A DiabetesTeam Member asked a question 💭
Macon, GA

Does anyone know if Medicare pays for the Dexcom or any diabetic devices you just wear on your body? I heard so many good things about them and how it makes taking and keeping up with your numbers so much easier. Any help appreciated
Thank you

April 20, 2023
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A DiabetesTeam Member

The answer is yes and no @A DiabetesTeam Member.
I see you haven't filled in your story or your treatments yet.

If you are insulin dependent, then with a prescription from your doctor, Medicare Will Authorize a cgm (Continuous Glucose Monitoring Device). Usually a Freestyle Libre 2, or a Dexcom G6.

If you are not insulin dependent, but deal with multiple lows - hypos, with documentation, and doctors prescription, Medicare will Authorize a cgm too.

Medicare Part B will typically pay for 80% of the cost of durable medical supplies, with prescription. So out of pocket is generally limited to about $40.00 for 28 days (2 sensors) for a Freestyle Libre 2. And about $60.00 for 30 days (3 sensors) of Dexcom G6.

If you go to the website for Abbott’s Freestyle Libre 2, and fill out the form, with prescription, you can get started with 1 free sensor.

So as I said at the beginning of this, the short answer is yes and no.

Good luck.
A cgm is an opportunity to see how each food, portion controlled, affects your blood glucose numbers. Experiment and Use it wisely to get a better understanding on how each food affects your diabetes journey. Baby steps.

And never give up, never surrender, never ever.
You got this.
Have a wonderful day.

April 21, 2023 (edited)
A DiabetesTeam Member

I live in Canada so it is different here. But basically Dexcom's are reserve for Type 1 diabetes (it is an autoimmune disease in which the pancreas is not working at all, therefore insulin is the go to medications for type 1 diabetics, hence reserving the dexcom for them. It is more difficult to control type 1 diabetes as everything affects the level of sugar, even exercises require a sliding scale based upoon how long they will be exercising (as in children and teens in school, some have to stop gym activities if their numbers are not stable).

Here in Canada the freestyle Libre is reserved to mostly insulin users only, or being on Sulfonylureas (which I was on them for 9 months and got hypos very frequently), but if you are known to have hypos one can be prescribed (I have a condition for over 30 yrs prior to becoming diabetic called Reactive Hypoglycemia, so being diabetic now I am allowed to have a CGM in the form of Freestyle Libre, my pharmacist prescribed it for me years ago (pharmacist in my Province are allowed to adjust diabetic medications and prescribe CGM if need be), when Covid started all doctors offices were shut down and we went into lockdown, fortunately my pharmacist knows me well, he is the one who lowered and weaned me off the Sulfonylureas with the access to my blood test and my Libre meter. Our medicare does not cover CGM's unless you are on insulin, they also do not covers needles and if on pill form medications you are only allowed 200 strips per year. I have private insurances through my spouse and they cover 70 % of prescriptions and they have been covering my CGM seeing it was prescribed for hypos with Sulfonylureas, and even when I went off diabetic medications they continue to cover due to my reactive hypoglycemia condition.

@A DiabetesTeam Member my mom had a son prior to me (before knowing my dad, so he would have been my half brother), but he passed away 48 hrs later as he was a premature 7 months pregnancy in 1961, his dad was a type 1 diabetic and my half brother was type 1 at birth, which back then no technologies existed that could have saved the baby, his lungs were not well formed either, so he died from collapsed lungs and type 1 at birth. Here is a link about the risk of type 1 parents to have a type 1 child :
https://diabetes.org/diabetes/genetics-diabetes....

April 21, 2023
A DiabetesTeam Member

Thank you Hkc that's good information. Congratulations on the new baby coming. I'm on insulin as of now because after being in the hospital a week ago they put me on strong steroids and since i came home on them they added Humalog and Levemeir to keep my sugar under control better. I have never been on insulin before it's very scary because I'm having lows in the morning and no one showed me how to used them so i was sent home with a sheet telling me how much of each one to use but the lows show me i must be taking to much. Any help would be appreciated

April 21, 2023
A DiabetesTeam Member

My WellCare pays for freestyle 2 and all my medications

April 21, 2023
A DiabetesTeam Member

I was denied the Dexcom because I am not on insulin. If I was taking it 3 times a week I would be approved but I think I would have a co-payment of $75 but not sure since I was told no. When it was getting up to 200 and past I would probably have been given it but I was seeing the doctor's assistant and she just said see a nutritionist. Getting the Ozempic shot finally has helped. It would be easier if we could all get the Dexcom but not have to take the insulin to get it. All type 1 diabetics get it.

My grandson was diagnosed as a teen. He is 26 years old now. His dad was diagnosed as a young child as a type 1. He is concerned his baby will have it too. We will have a revel party Saturday to find out if I will have a great-granddaughter or great-grandson at the end of August or beginning of September.

Have a great Friday
Ann in TN previously from WV

April 21, 2023

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