Medicare covers Dexcom continuous glucose monitors, but the coverage rules depend on which Medicare plan you have and whether your doctor prescribes it as medically necessary.
If you have Original Medicare (Part B), Dexcom G6 and Dexcom G7 are covered when your doctor writes a prescription stating that you have diabetes and meet specific criteria. Medicare pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent. If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower, but coverage rules vary by plan.
The key step is getting your doctor to document that the device is medically necessary for your care. Without that prescription and documentation, Medicare will not cover it, regardless of which plan you have. The process takes time — usually several weeks from prescription to first shipment — so planning ahead matters if you are thinking about switching to a Dexcom system.
Key Takeaways
- Original Medicare Part B covers Dexcom G6 and G7 at 80 percent of the approved amount after your deductible, with your doctor's prescription.
- Your doctor must document that continuous glucose monitoring is medically necessary for your diabetes management to trigger coverage.
- Medicare Advantage and Medigap plans have their own coverage rules, so you should contact your specific plan to learn your out-of-pocket costs.
- Dexcom requires a valid prescription and works with Medicare's approved suppliers, so ordering directly from Dexcom's website may not be covered.
How Original Medicare Part B Covers Dexcom
Under Original Medicare Part B, Dexcom G6 and Dexcom G7 are classified as durable medical equipment (DME). This means Medicare covers them the same way it covers wheelchairs, oxygen equipment, and other devices you use at home. You pay 20 percent coinsurance after you have met your annual Part B deductible (which is $240 in 2024, though this amount changes yearly).
The actual amount Medicare pays depends on the approved amount for your region, not Dexcom's retail price. Approved amounts vary by location and can be lower than what you would pay out of pocket if you bought the device without insurance. Once Medicare approves your claim, the supplier ships the device directly to you.
The entire process — from your doctor's prescription to receiving your first sensor — typically takes three to four weeks. During that time, you will need to continue using your current glucose monitoring method if you have one.
What Your Doctor Needs to Do
Your doctor must submit a prescription that states you have diabetes and that continuous glucose monitoring is medically necessary for your care. Medicare does not require a specific form, but your doctor's office should be familiar with submitting DME prescriptions to Medicare. If your doctor has never prescribed Dexcom before, their office may need to contact Dexcom's Medicare support team for guidance on the paperwork.
Some doctors may hesitate if they are not sure whether Medicare will cover it. If that happens, you can ask your doctor's office to contact Dexcom directly — Dexcom has a team that works with providers on Medicare coverage questions. You can also call Dexcom's customer service at 1-844-DEXCOM-1 (1-844-339-2661) and ask them to reach out to your doctor's office on your behalf.
Once your doctor submits the prescription, it goes to a Medicare-approved DME supplier. Dexcom is one of the suppliers Medicare works with, but your prescription may be filled through a different supplier depending on your location and Medicare's network agreements.
Medicare Advantage Plans and Dexcom Coverage
If you have a Medicare Advantage plan (Part C), your coverage for Dexcom depends entirely on your specific plan's formulary and DME coverage rules. Some Medicare Advantage plans cover Dexcom the same way Original Medicare does; others may have higher copays, require prior authorization, or cover only certain models.
The best way to find out is to call the customer service number on your Medicare Advantage card and ask directly: "Is Dexcom G6 or G7 covered under my plan, and what is my out-of-pocket cost?" Have your member ID ready. The plan representative can tell you whether you need prior authorization from your doctor and which supplier you must use.
Some Medicare Advantage plans also offer supplemental benefits that may reduce your costs further, so it is worth asking whether your plan has any diabetes management programs or equipment benefits beyond standard coverage.
Medigap Plans and Dexcom
Medigap plans (also called Supplemental Insurance) do not cover Dexcom directly. Instead, they work alongside Original Medicare by helping pay the coinsurance and deductibles that Medicare does not cover. If Original Medicare covers Dexcom at 80 percent, your Medigap plan may cover some or all of the remaining 20 percent, depending on which Medigap plan you have.
Medigap plans are standardized, so Plan G covers the same benefits whether you buy it from one company or another. Plans with higher premiums typically cover more of your out-of-pocket costs. If you have a Medigap plan, your out-of-pocket cost for Dexcom will be lower than it would be with Original Medicare alone, but the exact amount depends on your plan letter (A through N).
Ordering Through a Medicare-Approved Supplier
You cannot straightforward order Dexcom from Dexcom's website and submit the receipt to Medicare for reimbursement. Instead, your doctor's prescription must go to a Medicare-approved DME supplier. These suppliers are authorized by Medicare to bill insurance directly and to may support that all the paperwork is correct before shipping.
When your prescription is submitted, Medicare's system will route it to an approved supplier in your area. That supplier will contact you to confirm your address, insurance information, and any other details they need. They will then bill Medicare directly, and you will pay only your coinsurance amount (20 percent after your deductible) when you receive the device.
If you order from Dexcom's website without going through an approved supplier, you will pay the full retail price upfront and will not be reimbursed by Medicare. This is an important distinction — the supplier network exists to protect you from paying more than you should.
Costs and What to Expect
The amount you pay depends on your plan type and your deductible status. If you have Original Medicare and have not yet met your $240 Part B deductible, you will pay the full deductible first, then 20 percent of the approved amount for Dexcom. If you have already met your deductible, you pay only 20 percent.
The approved amount for Dexcom varies by region. In some areas, the approved amount may be $3,000 to $4,000 per year for sensors and transmitters combined; in others, it may be different. Your supplier will tell you the exact approved amount and your out-of-pocket cost before they ship the device.
If you have a Medigap plan, your coinsurance may be covered in full, meaning you might pay nothing out of pocket beyond your deductible. If you have a Medicare Advantage plan, your costs depend on your plan's specific rules — some plans have copays instead of coinsurance, and some may have different deductibles.
Frequently Asked Questions
Does Medicare cover the Dexcom G7 the same way it covers the G6?
Yes, Medicare covers both G6 and G7 as durable medical equipment under the same rules. The G7 is newer and has a shorter wear time, but from Medicare's perspective, the coverage and approval process are identical. Your doctor can prescribe whichever model they think is best for your care.
What if my doctor says Dexcom is not medically necessary?
If your doctor does not think continuous glucose monitoring is necessary, they will not write a prescription, and Medicare cannot cover it. You can ask your doctor to explain their reasoning and discuss whether Dexcom might help your diabetes management. If you disagree, you can seek a second opinion from another doctor or an endocrinologist.
Can I use my Dexcom from another country if I travel?
Dexcom sensors work internationally, but Medicare only covers the device when it is used in the United States. If you travel abroad, you will need to pay out of pocket for sensors while you are away. When you return, Medicare coverage resumes as normal.
How often does Medicare cover new sensors?
Medicare covers the sensors and transmitter you need for ongoing use. The frequency depends on how often your doctor prescribes them based on your diabetes management plan. Typically, this means sensors every 10 to 14 days (depending on the model) and a new transmitter every 90 days, but your doctor's prescription determines the exact schedule.
What happens if the supplier says my prescription was denied?
If Medicare denies your prescription, the supplier will tell you why — usually because your doctor's documentation did not meet Medicare's criteria, or because the prescription was incomplete. Ask the supplier for the specific reason and share it with your doctor. Your doctor can then resubmit with additional information or clarification. You have the right to appeal a denial as well.