CGM Coverage in Quebec
Does Quebec RAMQ provide Dexcom CGM coverage?
Yes, Dexcom CGM coverage is available through the Régie de l’assurance maladie du Québec (RAMQ).
To receive coverage for Dexcom CGM under RAMQ, you must meet the eligibility requirements for the Public Insurance Plan for self-monitoring of blood glucose in people living with diabetes aged 2 years or over.
To meet the criteria, you or your loved one must be:
- Under 18 years of age and have type 1 diabetes;
- Age 18 and over and be treated with intensive insulin therapy (treatment by insulin pumps or ≥ 3 insulin injections of at least two different insulins per day) and meet one or more of the following criteria:
- not reaching your specific A1C goal
- experiencing frequent episodes of hypoglycemia in the last year
- not able to recognize or signal hypoglycemia symptoms
Do I need a prescription to qualify for coverage?
Yes, you will need a valid prescription.
What do I need to get coverage approval?
The first step is to tell your physician or pharmacist that you’d like to receive a prescription for a Dexcom CGM System. The physician will then:
- Complete an Exceptional Medication Form and submit it to RAMQ for approval.
- Give you a prescription.
Once you have been approved, the pharmacy will process your order for Dexcom CGM supplies.
If RAMQ has already approved you for Dexcom G6 and you would like to start using Dexcom G7, ask your pharmacist to dispense G7 supplies.
How long am I approved for?
You will initially be authorized for a period of 6 months to assess your ability to use a Dexcom CGM System and wear the sensor.
After 6 months, you will be authorized to continue using Dexcom CGM if you are able to show optimal use of Dexcom CGM (wearing the sensor at least 70% of the time).
Your prescriber will complete an annual clinical reassessment to ensure you continue to use the sensor at least 70% of the time.
What if I have private insurance?
Private insurance plans must provide Dexcom CGM coverage at least equivalent to RAMQ. In practice, most private plans cover Dexcom CGM for plan members using any insulin. We suggest you contact your insurer for more details or speak with your pharmacist to verify your coverage.
Where can I get my Dexcom CGM supplies?
Dexcom CGM sensors must be purchased at your local pharmacy. Individuals without a compatible smart device are eligible for a free Receiver and should contact Dexcom Customer Service at 1-844-832-1810.
Will I have any out-of-pocket costs?
In some cases you may have out-of-pocket costs when purchasing at your pharmacy. If you find you do have a co-pay amount, the Dexcom Savings Program assists in reducing or even eliminating up to 20% of out-of-pocket costs.* Download a copy of the program certificate below, which can be redeemed at your pharmacy with a valid Dexcom G7 prescription.
Do you have questions?
Our team is here to help! One of our Insurance Specialists can assist you in determining your Dexcom CGM coverage. Please get started by filling out our online form or calling us at 1-844-832-1810.
*Based on reasonable upcharge, mark-up and customary pharmacy dispensing fee.
† Best available information as of February 12, 2024. Subject to change.
† Best available information as of February 12, 2024. Subject to change.