Continuous Glucose Monitors (CGMs)
Real-Time Glucose Tracking, Without Constant Finger Sticks
A continuous glucose monitor is a small, wearable sensor that tracks your glucose levels around the clock, sending readings to a receiver or smartphone every few minutes without the need for routine finger sticks. For many patients, a CGM makes it dramatically easier to spot trends, catch highs and lows before they become dangerous, and share detailed glucose data with a doctor during appointments. Because CGMs are classified as durable medical equipment, they’re covered by Medicare Part B, most Medicaid programs, and the majority of private insurance plans — provided you meet a specific set of clinical criteria.
CGM Brands Available
Dexcom G7
One of the most widely prescribed CGMs, the Dexcom G7 sends real-time glucose readings to a compatible smartphone or dedicated receiver every five minutes, with directional arrows showing whether glucose is rising, falling, or holding steady. The sensor is worn for up to 15 days before replacement and is FDA-approved for use in making treatment decisions without a confirmatory finger stick under most conditions.
FreeStyle Libre 3
Abbott’s FreeStyle Libre 3 is one of the smallest CGM sensors available, worn on the back of the upper arm for up to 14 days. It streams readings continuously to a compatible smartphone app, with published accuracy figures putting its mean absolute relative difference (a standard measure of CGM accuracy) among the lowest — meaning most tightly aligned with lab reference values — of any CGM currently on the market.
FreeStyle Libre 2 Plus
A continuous monitoring option with configurable high and low glucose alerts, offering similar core functionality to the Libre 3 for patients whose insurance plan or device compatibility favors this specific model.
Your doctor determines which specific CGM is appropriate for your treatment plan, and can note a preferred brand directly on your prescription.
Who Qualifies for CGM Coverage
Medicare and most private insurers apply a similar set of clinical criteria before approving CGM coverage:
- You use any type of insulin, or you have a documented history of problematic hypoglycemia even without using insulin. Problematic hypoglycemia is generally defined as recurring low blood sugar events (glucose below 54 mg/dL) despite adjustments to your treatment plan, or a single severe low blood sugar event requiring assistance from another person.
- Your CGM is prescribed to help improve your glycemic control, consistent with the device’s FDA-approved indication for use.
- You’ve been seen by your treating provider for diabetes management within the past six months, either in person or through a Medicare-approved telehealth visit.
- Your doctor documents that your treatment plan requires ongoing adjustment based on your glucose readings — whether from finger-stick testing or CGM data — unless your results already tend to stay within your target range.
Some private insurers apply additional or slightly different thresholds, such as requiring a minimum number of daily finger-stick tests or insulin doses. Our team verifies your specific plan’s exact criteria as part of the eligibility process, so you know precisely where you stand before submitting a request.
Keeping Your Coverage Active
Unlike a one-time purchase, CGM coverage generally isn’t a single approval that lasts indefinitely. Most insurers, including Medicare, require a follow-up visit with your treating provider roughly every six months after your CGM is first prescribed. During that visit, your provider documents that you’re still adhering to your CGM regimen, that the device remains medically necessary, and that your diabetes treatment plan continues to be actively managed using the data it provides. Missing this renewal window is one of the more common reasons a CGM refill gets unexpectedly denied — not because a patient no longer qualifies, but because the documentation lapsed. Our patient support team tracks these six-month windows on your account and can help coordinate the renewal visit with your doctor’s office proactively.
What’s Included With Your CGM Order
A CGM order typically includes the ongoing sensors that require regular replacement (every 10 to 15 days depending on the model) along with any required receiver or transmitter hardware. It’s worth noting that Medicare requires the use of a durable receiver — either a dedicated device or, in some cases, a receiver used alongside a smartphone app — rather than relying on a smartphone alone, since a phone by itself doesn’t meet Medicare’s technical definition of durable medical equipment. Our team confirms exactly what your specific plan requires before your first order ships, so there are no surprises about what’s covered.
How to Get Started
If you already use insulin or have discussed problematic low blood sugar events with your doctor, you may already meet the clinical criteria for CGM coverage. The fastest way to find out is a free eligibility check, where our team verifies your specific insurance plan’s requirements and confirms what, if anything, you’d owe out of pocket.
If you don’t yet have a prescription for a CGM, that’s not a barrier — our team can coordinate directly with your doctor’s office once you’ve discussed whether a CGM is appropriate for your treatment plan.
After Your First Order
Once your CGM coverage is set up, sensors are typically placed on an automatic refill schedule matched to your specific device’s wear cycle, so a new sensor arrives before your current one expires. If your prescribed CGM brand changes, or your usage pattern shifts, our support team can adjust your refill schedule directly.
Frequently Asked Questions
Does Medicare cover the Dexcom G7 and FreeStyle Libre 3?
Yes. Medicare Part B covers both, along with other FDA-approved therapeutic CGMs, for patients who use insulin or have a documented history of problematic hypoglycemia, provided a valid prescription and required documentation are on file.
Do I need to use insulin to qualify for a CGM?
Not necessarily. You can also qualify with a documented history of problematic hypoglycemia — generally recurring low blood sugar events or a severe episode requiring assistance — even if you don’t use insulin, provided your doctor documents this and the other coverage criteria are met.
How often do I need to see my doctor to keep CGM coverage active?
Most insurers, including Medicare, require a visit roughly every six months to confirm the CGM remains medically necessary and that you’re actively using the data as part of your treatment plan.
Can I use my CGM with just my smartphone?
Medicare specifically requires the use of a durable receiver, either a dedicated device or a receiver paired with your smartphone, since a phone alone doesn’t meet the technical DME definition. Some private insurers may have different requirements, which our team can confirm for your specific plan.
How long does a CGM sensor last before it needs replacing?
This depends on the specific device — commonly every 10 to 15 days — and your refill schedule is set up to match your prescribed CGM’s replacement cycle automatically.
What if my insurance requires prior authorization for a CGM?
Some private plans and Medicare Advantage plans require prior authorization before approving CGM coverage. Our team submits the required documentation on your behalf and follows up on the authorization status so you’re not left waiting without an update.
CGM coverage depends on your specific insurance plan, diagnosis, and prescription as determined by your treating physician. This page provides general information and is not a guarantee of coverage.