What Medicare Covers for Dexcom G6 Continuous Glucose Monitoring

Medicare's coverage of Dexcom G6

Medicare Part B covers the Dexcom G6 continuous glucose monitor for people with diabetes who meet specific requirements. The device itself, the sensors, and the transmitter are all covered, but you will pay a portion of the cost through your deductible and coinsurance. The exact amount you pay depends on whether you have Original Medicare or a Medicare Advantage plan, and whether you have supplemental coverage.

Medicare pays 80 percent of the approved amount for Dexcom G6 after you meet your Part B deductible (which is $240 in 2024, though this changes yearly). You are responsible for the remaining 20 percent coinsurance. If you have a Medigap policy or a Medicare Advantage plan, your out-of-pocket costs may be lower, depending on that plan's rules.

Key Takeaways

Medicare Part B covers Dexcom G6 for people with diabetes who use insulin and meet other medical requirements, paying 80 percent of the approved amount after your deductible.
You pay 20 percent coinsurance on top of your Part B deductible, unless you have a Medigap policy or Medicare Advantage plan that covers more.
Your doctor must order the device and confirm that you meet Medicare's medical criteria, which typically include insulin use and certain blood sugar patterns.
Sensors are replaced every 10 days and are covered under the same 80/20 split, so you will have ongoing coinsurance costs.
If you use a Medicare Advantage plan, contact your plan directly to learn what you will pay, because coverage rules vary by plan.

Who qualifies for Medicare coverage

Medicare covers Dexcom G6 only for people with diabetes who meet all of these conditions: you must use insulin, your doctor must prescribe the device as medically necessary, and you must have a diagnosis that supports continuous glucose monitoring. Most people who use insulin multiple times daily or use an insulin pump will meet these requirements.

Your doctor submits a prescription and medical documentation to Dexcom or to your durable medical equipment (DME) supplier. Medicare's contractor reviews the prescription to confirm you meet the criteria. This review usually takes a few days to a week. If you do not use insulin, or if your doctor cannot document that continuous monitoring is medically necessary for your care, Medicare will not cover the device.

What your out-of-pocket costs will be

Your costs depend on which type of Medicare coverage you have. With Original Medicare, you pay your Part B deductible ($240 in 2024) once per year, then 20 percent of the approved amount for the device and all sensors. The approved amount varies by region and supplier, but typically ranges from $3,500 to $4,500 per year for the full system including sensors.

If you have already met your Part B deductible for the year, you pay only the 20 percent coinsurance. If you have not met it, you pay the full deductible first, then 20 percent of the remaining cost. Sensors are replaced every 10 days, so you will have coinsurance costs roughly 36 times per year (every 10 days).

If you have a Medigap policy (supplemental insurance), the plan may cover some or all of your 20 percent coinsurance, depending on which Medigap plan you have. Plans C, D, G, and M typically cover the Part B coinsurance. If you have a Medicare Advantage plan, contact your plan to learn what you will pay — coverage varies widely between plans, and some plans may have different deductibles or coinsurance amounts.

How to order Dexcom G6 through Medicare

Start by talking to your doctor. Tell them you want to use Dexcom G6 and ask them to write a prescription. Your doctor will need to document that you use insulin and that continuous glucose monitoring is medically necessary for your diabetes management. This documentation becomes part of your medical record and is sent to Medicare's contractor for review.

Your doctor will either send the prescription directly to a Medicare-approved DME supplier, or they may give it to you to send yourself. Dexcom works with many DME suppliers, and you can also order directly from Dexcom if they are in-network with your Medicare coverage. Ask your doctor which supplier they recommend, or call Dexcom's Medicare support line to find a supplier near you.

Once the DME supplier receives your prescription, they submit it to Medicare for review. You should receive approval or a request for more information within 5 to 10 business days. After approval, the supplier ships the starter kit to your home. Your first sensor is included, and you will receive replacement sensors on a schedule (typically every 10 days).

Supplies and replacement sensors

The Dexcom G6 system includes a receiver, a transmitter, and sensors. The receiver is a handheld device that displays your glucose readings. The transmitter is a small pod that attaches to your skin and sends data wirelessly. Sensors are the adhesive patches that stick to your skin and measure glucose; they last 10 days and then must be replaced.

Medicare covers all of these components under Part B. Sensors are considered consumable supplies, so you receive new ones regularly — roughly 36 sensors per year. Each sensor replacement is subject to the same 20 percent coinsurance (after your deductible is met). If your transmitter breaks or stops working, Medicare covers a replacement, but you will need a new prescription from your doctor.

What to do if Medicare denies coverage

If Medicare denies your claim, you have the right to appeal. The denial letter will explain why coverage was denied and will tell you how to request an appeal. Most denials happen because the medical documentation did not clearly show that you use insulin or that continuous monitoring is medically necessary.

To appeal, gather any additional medical records that show your insulin use and your blood sugar patterns. Ask your doctor to write a letter explaining why Dexcom G6 is necessary for your care. Send this documentation to the Medicare contractor listed in your denial letter within 120 days. Many appeals are approved once the contractor receives clearer medical evidence.

Medicare Advantage plans and Dexcom G6

Medicare Advantage plans (Part C) must cover at least what Original Medicare covers, but they can add extra benefits or set different cost-sharing amounts. Some Medicare Advantage plans cover Dexcom G6 with lower coinsurance than the standard 20 percent, and some may waive the deductible for DME.

Before you order, call your Medicare Advantage plan and ask specifically about Dexcom G6 coverage. Ask what you will pay out of pocket, whether you need prior approval from the plan, and which DME suppliers are in-network. Plans change their coverage rules each year, so even if you had Dexcom G6 covered last year, confirm coverage for the current year.

Frequently Asked Questions

Does Medicare cover the Dexcom G6 receiver and transmitter?

Yes. Medicare covers the receiver (the handheld device that displays readings) and the transmitter (the pod that attaches to your skin) as part of the Dexcom G6 system. Both are covered under Part B at the 80/20 split after your deductible. You typically receive these items once in your starter kit, and replacements are covered if they malfunction.

What if I use a continuous glucose monitor from a different company?

Medicare also covers the FreeStyle Libre and Medtronic Guardian systems for people who meet the same medical criteria. Each system has different costs and coverage rules. Talk to your doctor about which system might work best for your diabetes management, and ask about the out-of-pocket costs for each option under your specific Medicare coverage.

Do I have to use a specific DME supplier to order Dexcom G6?

No. Dexcom works with many Medicare-approved DME suppliers. You can choose any supplier that is in-network with your Medicare coverage. Some people order directly from Dexcom if Dexcom is approved as a supplier in their region. Ask your doctor for a recommendation, or call Dexcom's Medicare support line to find suppliers near you.

Will my costs change if I switch from Original Medicare to a Medicare Advantage plan?

Possibly. Medicare Advantage plans set their own cost-sharing amounts for Dexcom G6, so your out-of-pocket costs may be higher or lower than the standard 20 percent coinsurance. Before you switch plans, compare the Dexcom G6 costs under your current plan and any new plan you are considering.

How often do I need to reorder sensors, and what is the cost?

Sensors are replaced every 10 days, so you need roughly 36 sensors per year. Each sensor order is subject to your 20 percent coinsurance (after your annual deductible is met). Your DME supplier typically ships sensors on a regular schedule so you do not run out. If you need sensors sooner, contact your supplier to request an early shipment.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.