08/26/2024 | Press release | Distributed by Public on 08/26/2024 14:06
Key takeaways:
Continuous glucose monitors (CGMs) make it easier for people with diabetes to check their blood glucose (sugar) without pricking their fingers multiple times a day. A CGM system typically includes sensors, an annual receiver (or a connected smart device), and sometimes a transmitter.
CGM systems can be costly if you don't have insurance. Depending on the brand, a CGM system can range from less than $2,000 to $7,000 a year. Though, the average cost is estimated at about $1,200 to $3,600 a year without insurance or discounts.
You can save money if your CGM works with your smartphone and you don't have to buy receivers.
Some insurance plans cover all or part of a CGM system. If you don't have insurance that covers CGM systems, GoodRx coupons and/or manufacturer savings programs can help you pay less for popular brands such as FreeStyle Libre and Dexcom.
People with diabetes often monitor their blood glucose (sugar) levels at home to prevent complications related to the condition, such as nerve damage, blurred vision, or dental problems. Many of those people prick their fingers multiple times a day and use test strips with a blood glucose meter (glucometer) to ensure their blood sugar is within their target range. This procedure can be painful and inconvenient, but it can be avoided by using a continuous glucose monitor (CGM).
CGMs make it easier to manage diabetes at home without fingerpricks. These systems use a small sensor, inserted under the skin, to automatically test and record your glucose levels throughout the day. This allows you to:
Use real-time feedback to improve your blood glucose levels
Detect changes in blood glucose levels
Increase the time you spend in your target range
Decrease the risk of certain conditions, such as hyperglycemia (when blood glucose levels are too high) and hypoglycemia (when blood glucose levels are too low)
These systems can help manage multiple types of diabetes including:
Gestational diabetes, a type of diabetes that occurs in some people during pregnancy
Without insurance or discounts, CGM costs - which include an annual receiver, sensors, and a transmitter if needed - can range from less than $2,000 to about $7,000 per year. But according to Forbes Health, CGM costs average $100 to $300 a month, which is $1,200 to $3,600 annually.
Medicare coverage for continuous glucose monitors (CGMs): CGMs are covered by Medicare when deemed medically necessary for enrollees who meet certain criteria.
Did you know diabetes supplies can cost more than insulin? In addition to medication, managing diabetes often requires certain medical supplies. Here are ways to save.
Dexcom vs. FreeStyle: These two popular CGM systems are similar, but they differ in how their sensors, transmitters, and receivers work. And Dexcom is more costly.
What you pay can vary based on the CGM brand and model you use. But, generally, you will need to purchase:
Replaceable sensors
A transmitter, unless it's part of the disposable sensor
A yearly receiver or reader, if needed
Cash-paying consumers may be able to save on these costs using free GoodRx coupons. You can also cut costs if your system allows you to use your smartphone in place of a receiver.
For instance, the Dexcom G6 and the newer Dexcom G7 can display data on either a smart device or a receiver. For the Dexcom G6 system, you'll need either an annual receiver or a smart device, a carton of sensors every month, and a transmitter. The Dexcom G7 works without a transmitter, requiring just sensors and a receiver or smart device.
Without insurance or discounts, the annual cost of the Dexcom G6 system - if purchasing a receiver - would be about $7,000. For the Dexcom G7, the cost is at least $5,000 a year if you use your smartphone for readings and about $450 more if you need a receiver.
Without insurance or discounts, the FreeStyle Libre systems cost about $2,000 annually. They cost less than the Dexcom systems because:
There's no separate transmitter to purchase.
The FreeStyle Libre 2 doesn't require a reader if you have a compatible smart device. These readers are meant to last for years and cost about $100.
The FreeStyle Libre 3 works only with smart devices.
So let's say you're using the FreeStyle Libre 3. With GoodRx coupons, you'd spend about $150 for 2 sensors, which are sold in pairs, without insurance. Each sensor lasts up to 14 days. That means you'd need at least 26 sensors (or 13 cartons) annually. To buy at least 13 cartons per year at about $150 each (with GoodRx coupons), you'd spend about $1,950 without insurance.
Without insurance or discounts, you could pay $450 or more per month for a Dexcom G6 or G7 CGM model- not counting the cost of an annual receiver. Here's an example of estimated cash costs (without insurance or discounts) for these Dexcom CGM systems.
Dexcom G6 |
Dexcom G7 |
|
1 receiver (one-time annual cost) |
||
3 sensors (30-day supply) |
||
1 transmitter (lasts 90 days) |
Not applicable |
If you don't have insurance or are self-pay, there are savings available through a GoodRx partnership to help make the Dexcom systems more affordable. This program may be able to save you $200 or more per month on the Dexcom G6 system. For the G7 system, the program may be able to save you $210 on every three sensors (a month's supply) and $240 on each receiver.
There's also a savings program available directly from Dexcom for cash-paying consumers that offers $200 off Dexcom G6 transmitters, as well as a patient assistance program for certain uninsured or underinsured consumers.
Here are some price estimates for the Dexcom G6 and G7 systems with GoodRx coupons.
Dexcom G6 |
Dexcom G7 |
|
1 receiver (one-time annual cost) |
||
3 sensors (30-day supply) |
||
1 transmitter (lasts 90 days) |
Not applicable |
Most health insurance plans will cover CGMs and their associated supplies if you have a prescription for the devices.
If you have original Medicare, Medicare Part B covers self-testing equipment and supplies as durable medical equipment for people with diabetes if you meet certain criteria. Covered items include:
CGMs and their associated supplies
Blood glucose meters (glucometers) and test strips
Lancet devices and lancets
Devices to confirm the accuracy of the testing equipment
Original Medicare will only pay upfront for CGMs and their associated supplies from pharmacies or suppliers that accept the assignment to fill your Medicare-covered prescription. If you fill your prescription at one of these locations, you only will be responsible for the coinsurance. But, if you fill your prescription at a location that doesn't accept Medicare, you may have to wait for Medicare to send you its share of the cost or pay everything yourself.
You may need a manual glucometer to check the accuracy of your CGM or for other reasons. How your plan covers a glucometer and the necessary supplies may depend on whether or not you take insulin. For example, you may be eligible for 300 lancets and 300 test strips every 3 months if you take insulin. If not, you may only be able to get coverage for 100 test strips and 100 lancets every 3 months. Though, Medicare may make a coverage exception and allow you to get more supplies beyond the standard allotment if your healthcare professional determines they are medically necessary.
Medicare Advantage plans cover CGMs and supplies at a level that matches or exceeds original Medicare. And most state Medicaid programs and Affordable Care Act (ACA) plans cover these devices. The devices are covered by Tricare for certain conditions.
According to Abbott, the maker of several FreeStyle Libre CGM systems, most people with commercial health insurance pay less than $40 per month out of pocket for sensors.
There are people who use CGMs who don't have Type 1 or Type 2 diabetes. Athletes, for instance, sometimes use these devices to help boost their mental or physical performance. And some people use them as a way to help prevent diabetes.
The first over-the-counter (OTC) CGM was cleared by the FDA in March 2024 and is expected to be available by the end of 2024. This means you'll be able to buy the device - which is recommended for people who don't take insulin - without a prescription. Abbott's Lingo, an OTC CGM for people who don't have diabetes, and Libre Rio, an OTC CGM for people who have diabetes but don't use insulin, were cleared by the FDA in June 2024.
While experts don't recommend CGMs for people who don't have diabetes, they say these devices may be helpful for people who have prediabetes (abnormal blood sugar levels). Though, health insurance may not cover CGM costs if you have prediabetes or gestational diabetes (versus Type 1 or Type 2 diabetes). Health insurance also does not typically cover CGM costs for people who don't have any form of diabetes, as summarized in the chart below.
Condition |
Will insurance likely cover a CGM system? |
No diabetes |
Probably not |
Prediabetes |
Maybe |
Gestational diabetes |
Maybe |
Type 1 diabetes |
Yes |
Type 2 diabetes |
Yes |
If you need more information, contact your insurance plan to find out if and how CGM systems for people who have not been diagnosed with Type 1 or Type 2 diabetes are covered.
People who use CGMs to monitor their blood glucose levels at home may need to purchase other essential supplies like:
Adhesive skin patches to keep the CGM attached
Blood glucose meter, lancets, and strips to calibrate the CGM
Smart device (such as a smartphone) to connect to the CGM
If you have Type 1 diabetes, you may need an artificial pancreas, which uses a CGM with an automated insulin delivery (AID) system. Artificial pancreas systems consist of the following:
CGM
Insulin pump
Software that determines how much insulin is needed and signals the pump when to deliver insulin
An AID system imitates a healthy pancreas and can help increase the amount of time your blood sugar is in a normal range. This system also can help prevent diabetes-related complications. An AID system can cost around $6,000 a year - and sometimes more - without insurance or discounts.
For many people with Type 1 diabetes, the out-of-pocket costs of diabetes technology, including CGMs, is a major issue. Even with health insurance, some people cannot afford these systems without financial help.
There are ways to get copay assistance and discounts on certain CGMs. As mentioned, the manufacturer of Dexcom systems offers a copay savings program for people with commercial health insurance and a patient assistance program for eligible individuals (regardless of insurance status).
GoodRx, meanwhile, offers discounts that could reduce the cost of certain CGM systems including:
Abbott's FreeStyle Libre systems are among the most affordable CGM systems. As mentioned, most people with commercial health insurance pay less than $40 a month for sensors that go with these systems. If you are asked to pay more than $75 for two sensors, you can contact the company's customer care team for a voucher to pay less. If you have commercial insurance or are self-pay, you may qualify for a free sensor through the MyFreeStyle program.
Some CGM systems come with free trials. People with Type 1 or Type 2 diabetes may qualify for a free Dexcom G7 10-day sensor, if they are new users of this CGM device. And Abbott provides a free 14-day sensor for the FreeStyle Libre 2 or FreeStyle Libre 3 system for new users.
In most cases, yes, you can apply the tax-advantaged funds from a health savings account (HSA) or a flexible spending account (FSA) toward the costs of a CGM.
An HSA is for people with high-deductible health plans. You can use an HSA to pay for qualified healthcare expenses, and it belongs to you, rather than being attached to your employer.
FSAs are sponsored by employers, who set an annual contribution limit. You have to use the funds from an FSA by the end of the calendar year or you risk losing them.
Continuous glucose monitors (CGMs) are useful for people whose glucose levels need ongoing observation. Unlike glucometers that use test strips, these systems don't require multiple fingerpricks a day. However, CGM systems can be costly - especially if your health insurance doesn't cover them.
Costs typically vary based on the brand and the required individual components, such as a transmitter and replaceable sensors. Without insurance or discounts, CGM costs can range from less than $2,000 to $7,000 annually. The average yearly cost for a CGM system is estimated at $1,200 to $3,600. GoodRx coupons and/or manufacturer savings programs can help you pay less for the popular Dexcom and FreeStyle Libre systems.
Addala, A., et al. (2021). Cost considerations for adoption of diabetes technology are pervasive: A qualitative study of persons living with type 1 diabetes and their families. Diabetic Medicine.
American Diabetes Association. (n.d.). CGMs.
American Diabetes Association. (n.d.). Understanding diabetes diagnosis.
Capoot, A. (2024). FDA approves two new Abbott over-the-counter continuous glucose monitors. CNBC.
Centers for Disease Control and Prevention. (2024). About gestational diabetes.
Centers for Medicare & Medicaid Services. (2022). Medicare coverage of diabetes supplies, services & prevention programs.
Dexcom. (n.d.). Dexcom savings center.
Dexcom. (n.d.). Explore and compare Dexcom CGM products.
Dexcom. (n.d.). G6 overview.
Dexcom. (n.d.). G7 overview.
FreeStyle Libre. (n.d.). Cost and coverage.
FreeStyle Libre. (n.d.). Private insurance.
Klonoff, D. C., et al. (2022). Use of continuous glucose monitors by people without diabetes: An idea whose time has come?Journal of Diabetes Science and Technology.
Medicare.gov. (n.d.). Continuous glucose monitors.
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Artificial pancreas.
National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Continuous glucose monitoring.
Rodbard, D. (2017). Continuous glucose monitoring: A review of recent studies demonstrating improved glycemic outcomes. Diabetes Technology & Therapeutics.
Silva, L. (2023). How much does a continuous glucose monitor cost? Forbes Health.
Tricare. (2023). Does Tricare cover continuous glucose monitors?
Yan, K., et al. (2021). CGM and Medicaid: Who's covered? DiaTribe Change.
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