CGM Coverage in Newfoundland and Labrador
Does Newfoundland and Labrador provide Dexcom CGM coverage?
Yes, coverage for Dexcom G6 and Dexcom G7 is available through the Newfoundland and Labrador Health Services (NLHS) CGM pilot program for people living with Type 1 diabetes who:
- Permanent resident of NL
- Hold a valid Medical Care Plan (MCP)
- Under 18 years of age (or >18 years who are under the medical care of a pediatric diabetes care team)
- Undergoing one of the following treatments
- Use of an insulin pump with hybrid closed-loop software capability
- Multiple daily injection therapy using rapid-acting analog insulin
Both Dexcom G6 and Dexcom G7 are eligible benefits under the NLHS CGM pilot program.
Do I need a prescription to get Dexcom CGM?
Yes, you will need a valid prescription for either Dexcom G7 or Dexcom G6.
What do I need to do to apply for coverage approval?
To participate in the pilot program, request an application package by emailing [email protected]. The package includes the Application Form and the Verification of Medical Eligibility Form to be completed by you and your health care provider. Submit these completed forms along with confirmation of private insurance* to [email protected] or by fax to 709-777-6027.
*Failure to disclose third-party insurance coverage may result in termination of benefits. Should there be a change in insurance coverage or if benefits are maxed out, please obtain an explanation of benefits from your insurance company, and send it to the program by email or fax.
How long am I approved for?
Coverage approvals last up to one year.
Where can I get my Dexcom CGM supplies?
Once you’re approved for coverage, and obtained your pharmacy payment certificate from Dexcom, you can access your Dexcom G6 or G7 CGM supplies at your local pharmacy.
Will I have any out-of-pocket costs?
The NLHS CGM Pilot Program is the payor of last resort. If you do not have private or third-party insurance or if your private insurance coverage has been used, then your CGM device and supplies will be covered under the CGM Pilot Program. Between your private insurance and the Program, you should have minimal out-of-pocket expense.
To assist with the coordination coverage in pharmacy, Dexcom Canada is providing all patients approved for NLHS coverage assistance for Dexcom CGM supplies with a custom pharmacy payment certificate. Each patient-specific certificate is programmed to enable their NLHS-approved coverage to be applied to their purchases of Dexcom G6 CGM or G7 CGM supplies in pharmacy in real-time.
Do you have questions?
Our team is here to help! One of our Insurance Specialists can assist you in determining your coverage for Dexcom CGM. Get started by filling out our online form or call us at 1-844-832-1810.
*Based on reasonable upcharge, mark-up and customary pharmacy dispensing fee.
† Best available information as of June 14, 2024. Subject to change.
† Best available information as of June 14, 2024. Subject to change.