Does Medicare cover continuous glucose monitors?

Yes. In fact, Medicare increased its coverage for continuous glucose monitors in April 2023. Introduced in 1999 to enable people with diabetes to regularly monitor their blood sugar levels, a continuous glucose monitor (CGM) attaches to your body to keep track of glucose levels in real time.

The Centers for Medicare & Medicaid Services expanded continuous glucose monitor coverage to any Medicare recipient prescribed insulin to treat diabetes, regardless of insulin type or amount. That change in 2023 made approximately 1.5 million more people eligible for the coverage.

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Medicare has been increasing several types of coverage for diabetes, offering prediabetes programs and implementing a $35 out-of-pocket insulin cap. These changes in coverage can help reduce the risk of developing more expensive conditions, such as chronic kidney disease, which costs Medicare almost $125 billion each year.

The previous rules limited continuous glucose monitor coverage to people who receive three or more injections of insulin a day or who have an insulin infusion pump.

How do continuous glucose monitors work?

The device inserts a tiny sensor under your skin, usually on your arm or abdomen, to measure glucose in fluid between your cells 24 hours a day. The sensor transmits information wirelessly to a wearable device or smartphone. Sometimes, a monitor comes as part of an insulin pump.

Continuous glucose monitors haven’t replaced finger-prick tests that register glucose levels only at the time of testing. Monitors continuously keep track of your glucose level and let you know if your blood sugar readings are trending high or low.

CGMs not only help you manage your blood sugar levels better but also guide your doctor in adjusting your insulin dose or diet. The monitor sends an alert if your reading reaches a certain level, but you may still need to do finger-stick tests to calibrate the device.

People with type 1 or type 2 diabetes who use a continuous glucose monitor have fewer instances of hypoglycemia, also known as low blood sugar, as well as a lower A1C — your average blood sugar levels over a three-month period — the American Diabetes Association says.

A1C levels are commonly used to diagnose prediabetes and diabetes. Higher readings are linked to diabetes complications, so managing your A1C level is important.

Medicare also covers blood sugar self-testing equipment, test strips and lancets for people with diabetes.