What health insurance covers Dexcom? Is it covered by Medicare? Let’s find out here.
What Health Insurance Covers Dexcom?
The Dexcom G6 Continuous Glucose Monitoring (CGM) System is covered by several health insurance policies. And yes, Medicare will cover it if you meet the coverage criteria.
If you have Medicare and you need Dexcom G6, then you need to prove that you have type 1 or type 2 diabetes. You also need to prove that you need it to manage your insulin intensively.
The company will ship Dexcom G6 to your doorstep free of charge if you’re a Medicare subscriber and you meet the criteria.
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What are the Requirements to Get Reimbursement for Dexcom?
- You’ve been diagnosed with diabetes.
- You’re getting more than three daily administrations of insulin.
- Your insulin treatment needs frequent adjustments.
- You previously visited your treating doctor six months before ordering CGM. The practitioner should have evaluated your diabetes control and find out whether or not you’ve met the cretics of getting Medicare coverage.
In addition to the criteria above, your receiver should be compatible with Dexcom G6.
Your health insurance may not cover Dexcom G6 supplies that can only be used with a mobile device.
Even though many health insurers offer Dexcom coverage, the benefits will depend on an individual policy.
How Does CGM Work?
CGM devices allow patients and healthcare providers to identify patterns in diet and blood glucose levels that would otherwise be difficult to determine.
This device operates through a glucose sensor placed below the skin’s surface. It’s held in place using an adhesive patch.
You can wear its sensors for up to 14 days continuously to transmit blood glucose levels to a reader every few minutes. In that case, the reader gets a lot of data.
With more data, your doctor can help you better manage your diabetes. This type of monitoring system is shown to be better at assisting patients with type 1 diabetes to lower their HBA1C compared to traditional self-monitoring.
The said device will also make it easier to predict hypoglycemia and hyperglycemia events. This is especially useful if you have erratic blood glucose levels. It’s also useful for children who can’t monitor their diabetes numbers.
Furthermore, users can see the effects instantly on their behavior and adjust it accordingly. In that case, you’re likely to skip dessert if you see its immediate effects on your blood glucose levels.
It may be a small change. But it can have a huge impact on your health.
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What is the Cost of a CGM Device?
It’s significant if you pay for it with your own money. The amount is more than the traditional blood glucose monitoring system.
But you will need prescriptions for different items and obtain them at a retail pharmacy if you don’t have health insurance that covers it.
The average cost can go around $6000 a year or $500 a month. It’s prohibitive for most people.
That’s why it’s truly good news when Medicare announced that it’s going to cover Dexcom. Other health insurers have also followed suit.
Conclusion
What health insurance covers Dexcom? Medicare and other private health insurance companies are offering coverage for this device. Talk to your health insurer about it.
Find out more about what your health insurance covers here.
Jane is a licensed medical technologist who bridges the gap between clinical precision and digital innovation. While her formal background is rooted in the meticulous world of laboratory science, her passion lies in the logic of software development. When she isn’t analyzing data or writing clean, efficient code, you can find her on the golf course, applying that same focus and discipline to her swing.