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Last Updated: July 21, 2020

Does Medicare cover Dexcom G6?

Yes. The Dexcom G6 Continuous Glucose Monitoring (CGM) System is covered by Medicare for patients who meet the Medicare coverage criteria. Medicare coverage for therapeutic CGM includes certain beneficiaries who have either type 1 or type 2 diabetes and intensively manage their insulin. Dexcom now ships Dexcom G6 to Medicare patients with traditional fee-for-service coverage. For a full description of coverage criteria, click here 

Medicare Coverage Criteria

Medicare patients with type 1 and type 2 diabetes on intensive insulin therapy may be able to obtain reimbursement if the following Medicare coverage criteria are met:

  • The patient has diabetes;
  • The patient has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing;
  • The patient is insulin-treated with three or more daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump;
  • The patient's insulin treatment regimen requires frequent adjustments based on therapeutic CGM testing results;
  • Within six months prior to ordering the CGM, the patient had an in-person visit with the treating practitioner to evaluate their diabetes control and determine that the above criteria have been met; and Every six months following the initial prescription of the CGM, the patient has an in-person visit with the treating practitioner to assess adherence to their CGM regimen and diabetes treatment plan.

In order to qualify for Medicare coverage of your Dexcom G6 supplies, Medicare requires that you have a receiver that is compatible with Dexcom G6 and that you use that receiver with your supplies, even if you also use a compatible smart device.* Medicare does not cover Dexcom G6 supplies that are only used with a smartphone or other mobile device.

For a full description of coverage criteria, click here.

*To view a list of compatible smart devices, visit dexcom.com/compatibility

 

I am an existing Medicare customer. How do I get my ongoing Dexcom G6 supplies?

As part of Dexcom’s mission to focus more on innovation and product improvement, Dexcom will be discontinuing its role as a Medicare-enrolled supplier of medical equipment. This means that effective September 1, 2020, Dexcom will no longer be able to submit claims to Medicare on your behalf. 

If you haven’t already, please connect with our dedicated Medicare transition support team at 844-535-9105 by August 15, 2020, during the hours of 6:00 am to 5:00 pm PST, to start the transition process to a Medicare supplier of your choice. Our Dexcom support team will transfer your Dexcom product orders and prescription file to your new supplier to avoid a potential disruption of your therapeutic CGM. View our full list of participating distributors.

For those Medicare beneficiaries who do not select a new Medicare-enrolled supplier by August 15, 2020, we will have your prescription files automatically transferred to one of the suppliers listed to minimize service disruptions. That supplier will reach out to assist you with future orders or you can switch to a supplier of your choice at any time. 

Dexcom is proactively reaching out to our major Medicare-enrolled supplier purchasers to make sure they are prepared to receive new patient orders for our products. If you already order other diabetes-related products from one of these major suppliers, you will likely hear from us or them in the coming days with an opportunity to expand on that existing supplier-patient relationship and transfer your CGM prescription file to that supplier automatically.  
 

I am a new Medicare customer. How do I get my Dexcom G6?

Dexcom G6 is available to Medicare patients at their local Walgreens or through a medical distributor (see distributor list below).

If you prefer to get your product through Walgreens, follow these steps:

1. Ask your doctor to prescribe to your chosen Walgreens

2. Take your red, white, and blue Medicare card as well as any supplemental coverage cards to Walgreens to ensure you only owe your copay

3. Pick up your Dexcom G6 System Continue visiting Walgreens to pick up your Dexcom G6 ongoing supplies.

 

What if I do not live near a Walgreens?

If there is not a Walgreens in your area, Walgreens will ship your Dexcom G6 and supplies directly to you at no additional cost.

If you cannot or choose not to fill your Dexcom G6 at Walgreens, you can choose to go through one of the participating distributors listed below. Please call your insurance plan to confirm the supplier is in your network.

 

 

Distributor Phone Number
Byram Healthcare 800-775-4372
CCS Medical 800-949-6481
US Med 877-659-9875
Solara Medical Supplies 800-423-0896 option 2
Edgepark 866-400-5183
USHL 866-421-2732
Edwards Healthcare 877-367-2444
Advanced Diabetes Supply  877-838-3026
Diabetes Management Supply 888-738-7929
BLN 877-261-2179
Mini Pharmacy 888-545-6464

 

Will Dexcom provide my diabetes testing supplies?

No. Blood glucose monitoring (BGM) supplies are not included in your CGM product shipments because Dexcom G6 does not require fingerstick calibrations.* You must purchase any BGM testing supplies that you need for the future.

*If your glucose alerts and readings from the Dexcom G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

 

How can I view my glucose data?

Medicare does not cover Dexcom G6 CGM supplies that are used only with a smartphone or other mobile device. Failure to use your receiver will result in loss of Medicare coverage for your Dexcom G6 CGM supplies.

CMS Policy

Coverage of CGM system supplies and accessories are available for those therapeutic CGM systems where the beneficiary uses a receiver classified as DME to display glucose data. There is no Medicare benefit for supplies used with equipment that is not classified as DME. However, Medicare coverage is available for the CGM system supplies and accessories if a non-DME device (smartphone, tablet, etc.) is used in conjunction with the durable CGM receiver. Coverage of CGM system supplies and accessories are available for those therapeutic CGM systems where the beneficiary uses a receiver classified as DME to display glucose data. If a beneficiary intends to never use a receiver classified as DME as the display device, the supplies and accessories are not covered by Medicare.

Here are some examples of how a Medicare patient may use a smart device with their receiver:

    • A patient uses both a receiver and a smartphone throughout the day
    • A patient uses a receiver some days of the week and their smartphone other days of the week
    • Patients should reach out to 1-800-MEDICARE with any questions about the Medicare coverage requirements for Dexcom CGM.

 

Is my smart device compatible with Dexcom G6?

For a list of compatible devices, visit www.dexcom.com/compatibility.

 

I have a compatible smart device. How do I use my smart device to see my Dexcom G6 readings?

1. Go to the App Store or Google Play store from your smart device. Search for “Dexcom G6”. Download and open the app.

2. Create account or log in using your Dexcom account. For example, a Dexcom CLARITY account.

3. Follow the instructions in the app. When asked, enter the serial number (SN) of the transmitter you're wearing. This can be found on the transmitter box, back of the transmitter or in your Receiver Settings.

4. Your app joins your current sensor session.

In order to qualify for Medicare coverage of your Dexcom G6 supplies, Medicare requires that you have a receiver that is compatible with Dexcom G6 and that you use that receiver with your supplies, even if you also use a compatible smart device. Medicare does not cover Dexcom G6 supplies that are only used with a smartphone or other mobile device.

 

How do I set up Dexcom Share, so that other people can see my glucose numbers?

Dexcom Share is a feature of the Dexcom G6 app. To set up Dexcom Share, press the Share icon (the triangle in the upper right hand corner of the screen) and follow the instructions. The app will walk you through sending invitations to up to 10 Followers. Your Followers will need to download the Dexcom Follow app to see your data.*

*For a list of compatible devices, visit www.dexcom.com/compatibility

† Separate Follow App required.

 

How much can I expect to pay for my Dexcom G6 CGM System if I’m a Medicare customer?

Generally, Medicare patients pay 20% out of pocket.

 

I need help getting started. What can I do?

Visit www.dexcom.com/medicare to view online training videos. These videos can walk you through the steps to get started, including receiver and app set-up, and downloading Dexcom CLARITY

Still need help? Call Dexcom Product Education & Training to speak with a Diabetes Coach at 877-339-2664.

For technical troubleshooting, our specialists are available 24/7 at 844-607-8398.

LBL019479 Rev001
 

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Dexcom G6 CGM System Guides

Need Additional Help?

Submit a Tech Support Request

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Available Monday - Sunday, 7AM - 9PM (PDT)