Medicare coverage for continuous glucose monitors has expanded significantly since the program first began covering CGMs in 2017. As of 2026, more Medicare beneficiaries than ever qualify for a CGM sensor at minimal out-of-pocket cost. This guide explains who qualifies, which devices are covered, and how to navigate the process.
Who Qualifies for Medicare CGM Coverage
To receive a Medicare-covered continuous glucose monitor, a beneficiary must meet all of the following criteria established by the Centers for Medicare & Medicaid Services (CMS):
1. **Diabetes diagnosis:** The beneficiary has a diagnosis of type 1 diabetes, type 2 diabetes, or another form of diabetes (gestational diabetes is excluded). 2. **Insulin use or frequent testing:** The beneficiary either uses insulin (via injection or pump) or performs 4 or more fingerstick blood glucose tests per day. 3. **Physician order:** A treating physician must write a prescription for the CGM and document medical necessity. 4. **In-person visit:** The beneficiary must have had an in-person or telehealth visit with their prescribing physician within the 6 months preceding the CGM order.
In a significant policy change effective January 2024, CMS expanded eligibility to include insulin-using beneficiaries who require only 1 or more daily insulin injections—down from the previous requirement of 3 or more injections per day. This change opened CGM access to millions of Medicare beneficiaries with type 2 diabetes who use basal insulin alone.
Which CGM Devices Medicare Covers
Medicare Part B covers CGMs classified as "therapeutic" devices. As of 2026, the covered devices include:
- **Dexcom G7** and **Dexcom G7 15-Day** (sensors, transmitter included in sensor) - **Dexcom G6** (sensors and transmitters) - **Abbott FreeStyle Libre 3** and **Libre 3 Plus** (sensors and reader, though most users use the smartphone app) - **Abbott FreeStyle Libre 2** (sensors and reader) - **Medtronic Guardian 4** (sensors and transmitter, when used with compatible pump) - **Eversense E3** and **Eversense 365** (implantable sensors, transmitters, and insertion/removal procedures)
Over-the-counter CGMs such as Dexcom Stelo and Abbott Lingo are not covered because they are classified as wellness devices, not therapeutic devices.
Part B vs. Part D
CGMs are covered under Medicare Part B as durable medical equipment (DME), not under Part D (the prescription drug benefit). This distinction matters because Part B has a standard 20 percent coinsurance after the annual deductible ($257 in 2026), while Part D cost sharing varies by plan.
Beneficiaries who also have a Medicare Supplement (Medigap) plan may have their 20 percent coinsurance covered in full. Those enrolled in Medicare Advantage plans should check their plan's DME benefit, which typically mirrors traditional Medicare coverage but may require using in-network suppliers.
Monthly Cost for Beneficiaries
Under traditional Medicare Part B, the beneficiary pays 20 percent of the Medicare-approved amount for CGM supplies. The typical monthly cost breakdown for a Dexcom G7 in 2026:
- Medicare-approved amount: approximately $280/month - Medicare pays: $224 (80 percent) - Beneficiary pays: $56 (20 percent)
For the Abbott Libre 3, the cost is slightly lower:
- Medicare-approved amount: approximately $180/month - Medicare pays: $144 (80 percent) - Beneficiary pays: $36 (20 percent)
Beneficiaries with financial hardship may qualify for manufacturer patient assistance programs. Dexcom and Abbott both offer copay assistance for eligible Medicare patients, potentially reducing the out-of-pocket cost to $0.
How to Get Started
The process for obtaining a Medicare-covered CGM involves 3 steps:
1. **Physician visit:** Discuss CGM benefits with your doctor and ensure documentation supports medical necessity. 2. **Prescription:** Your physician writes a CGM prescription specifying the device and quantity. 3. **DME supplier:** Contact a Medicare-enrolled DME supplier (pharmacy or mail-order company) to process the order and handle Medicare billing.
Processing typically takes 7-14 business days. Once approved, supplies are shipped on a recurring monthly or quarterly basis. Re-certification by your physician is required every 6 months to maintain coverage without interruption.
