Continuous glucose monitors
Medicare may cover a continuous glucose monitor and related supplies if you’re eligible
Description
Continuous glucose monitors track your glucose (blood sugar) levels through a device that's attached to your body.
Coverage details
Medicare covers different kinds of durable medical equipment (DME) in different ways. Depending on the type of equipment:
- You may need to rent the equipment.
- You may need to buy the equipment.
- You may be able to choose whether to rent or buy the equipment.
- Some items become your property after you’ve made a certain number of rental payments.
Who's eligible
If you have diabetes, Medicare may cover a continuous glucose monitor and related supplies if your doctor or other health care provider prescribes them for you and you meet the following conditions:
- You take insulin or have a history of problems with low blood sugar (hypoglycemia).
- Your health care provider has decided that you or your caregiver have had enough training to use a continuous glucose monitor as prescribed.
Provider requirements
Before your health care provider prescribes a continuous glucose monitor, they must meet with you to evaluate your condition and decide if you qualify for one.
Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask a supplier if they participate in Medicare or will accept assignment of your claims before you get DME.
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).
If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount). A non-participating provider doesn't have to accept assignment of your claims, but may choose to do so in your case. If DME suppliers aren't participating suppliers or won't accept assignment of your claims, you may be charged more. For rented DME, make sure the supplier is willing to accept assignment of your claims for all rental months. If the claim isn't assigned, you must pay for the full cost upfront. If this happens, Medicare will pay you later for the amount it covers after your claims have been processed.