Medicare's Continuous Glucose Monitor Coverage in 2024

Medicare Part B covers continuous glucose monitors (CGMs) for people with diabetes who meet specific requirements, and the rules did shift in 2024. The main change: Medicare now covers CGMs for a broader group of people with type 2 diabetes who use insulin, not just those on multiple daily injections. If you use insulin to manage your diabetes—whether through injections, a pump, or any other method—you may now be covered. The device itself, the sensors, and the transmitter are all included under Part B's durable medical equipment benefit.

Before 2024, Medicare's coverage was narrower. You had to be on multiple daily insulin injections (at least three per day) or using an insulin pump. Now, if you take any insulin at all—even once daily—you may meet the requirement. This matters because many people with type 2 diabetes were previously told they did not may have access to, even though they used insulin regularly.

Key Takeaways

  • Medicare Part B now covers CGMs for people with diabetes who use any form of insulin, not just those on multiple daily injections or pumps.
  • You will need a prescription from your doctor, and your doctor must document that the CGM is medically necessary for your diabetes management.
  • Medicare covers the monitor, sensors, and transmitter, but you pay 20% coinsurance after you meet your Part B deductible.
  • If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower than the standard 20% coinsurance.
  • Coverage does not include the receiver device if you use your smartphone as the display, but it does cover the transmitter and all sensors.

Who Qualifies Under the 2024 Rules

To be covered by Medicare Part B for a CGM in 2024, you must have diabetes and use insulin. That is the core requirement. You do not have to be on a specific number of injections per day, and you do not have to use a pump. If your doctor prescribes insulin as part of your diabetes treatment, you meet this part of the rule.

Your doctor must also write a prescription stating that the CGM is medically necessary for you. This is not automatic—your doctor has to document why monitoring your blood sugar continuously will help manage your condition. Most doctors who prescribe insulin will support this, but you may need to ask your doctor to submit the documentation to Medicare or to the DME supplier.

If you have type 1 diabetes, you have always may have access to for CGM coverage under Medicare. The 2024 change mainly opened the door for more people with type 2 diabetes who use insulin.

What Medicare Pays and What You Pay

Medicare Part B covers the CGM device, all sensors, and the transmitter. Once you meet your annual Part B deductible (which is $240 in 2024, though this amount changes yearly), Medicare pays 80% of the approved amount, and you pay 20% coinsurance. The exact cost depends on the device you choose and the supplier you use, because different manufacturers have different approved amounts.

A typical CGM system costs between $3,000 and $4,000 per year when you add up the device, transmitter, and sensors. If Medicare approves $3,500 for your system, you would pay 20% of that after your deductible—roughly $700 per year out of pocket. If you have already met your deductible earlier in the year for other services, your coinsurance starts right away.

If you have a Medigap policy (supplemental insurance), it may cover some or all of your 20% coinsurance, depending on which Medigap plan you have. If you have a Medicare Advantage plan, your costs depend on that plan's rules—some cover CGMs with a copay, others with coinsurance, and some may have different deductibles. Check your plan documents or call the plan directly to find out your exact cost.

How to Request a CGM From Medicare

Start by talking to your doctor. Tell them you are interested in using a continuous glucose monitor and ask whether they think it would help your diabetes management. If your doctor agrees, they will need to write a prescription and submit documentation to Medicare or to a durable medical equipment (DME) supplier that works with Medicare.

You can also contact a Medicare-approved DME supplier directly. They can tell you which CGM brands they carry and help you understand the cost. The supplier will work with your doctor to get the prescription and the medical necessity documentation. Once Medicare receives everything, it typically takes one to two weeks for approval.

If Medicare denies your request, you have the right to appeal. Ask the DME supplier or your doctor's office for the denial letter, which will explain the reason. You can request an appeal through your Medicare plan or by contacting Medicare directly at 1-800-MEDICARE.

Which CGM Brands Medicare Covers

Medicare covers several continuous glucose monitor systems, including the Dexcom G6, Dexcom G7, FreeStyle Libre, and Medtronic Guardian. The list can change, and not all suppliers carry all brands. When you contact a DME supplier, ask which systems they have in stock and which ones are covered under your specific Medicare plan.

Each system works slightly differently. Some send readings to your smartphone, others use a separate receiver, and some do both. Medicare covers the transmitter and sensors for all approved systems, but if you use your phone as the display, Medicare does not pay for the phone itself—only for the transmitter and sensors. Ask your doctor or the DME supplier which system might work best for your lifestyle and how often you need to replace sensors.

What to Ask Your Doctor

Before you request a CGM, have a conversation with your doctor about whether it makes sense for you. Here are the questions to ask:

  • Do you think a continuous glucose monitor would help me manage my diabetes better?
  • Will you write a prescription for a CGM and submit the medical necessity documentation to Medicare?
  • Which CGM system do you recommend, and why?
  • How often will I need to replace the sensors, and what is the typical cost after insurance?
  • If Medicare denies my request, will you help me appeal?

When to Contact Medicare or Your Plan

Contact Medicare at 1-800-MEDICARE if you have questions about whether you may have access to, if you want to know the approved amount for a specific CGM, or if you received a denial and want to understand the reason. You can also visit Medicare.gov and search for "continuous glucose monitor" to see the current coverage rules.

If you have a Medicare Advantage plan, call the plan directly before you request a CGM. Some Advantage plans have additional requirements or may cover only certain brands. Your plan's customer service number is on your insurance card. If you have a Medigap policy, you do not need to contact them before requesting a CGM—Medigap works alongside Medicare—but you may want to call to ask whether they cover coinsurance for DME.

Frequently Asked Questions

Do I have to use a specific brand of CGM?

No. Medicare covers several brands, and you can work with your doctor and DME supplier to choose the one that fits your needs. Some people prefer the Dexcom system because it sends alerts to a smartphone; others like the FreeStyle Libre because it does not require fingerstick calibration. Ask your doctor which brand they recommend and which ones your local DME suppliers carry.

What if my doctor says I do not need a CGM?

Your doctor's opinion matters, because Medicare requires a prescription and a statement that the CGM is medically necessary. If your doctor does not think you need one, Medicare will not cover it. You can ask your doctor to explain their reasoning, or you can request a second opinion from an endocrinologist or diabetes educator who specializes in CGM use.

Will Medicare cover a CGM if I use insulin only at night?

Yes. The 2024 rule covers anyone who uses insulin, regardless of how many times per day or when they use it. If your doctor prescribes insulin as part of your diabetes treatment and documents that a CGM is medically necessary, you meet the requirement.

Can I use my old CGM if I already own one?

Medicare covers the sensors and transmitter, not a device you already own. If you have an older CGM system, you would need to switch to one that Medicare covers in order to have the ongoing sensors and transmitter paid for. Talk to your doctor and DME supplier about whether upgrading makes sense for you.

What happens if I stop using insulin?

If you no longer use insulin, Medicare coverage for a CGM would end. Your doctor would need to document that you still need the device for another reason (such as managing hypoglycemia risk), but the standard coverage rule requires insulin use. If your diabetes management changes, talk to your doctor about what monitoring tools will still be covered.