Does Medicare cover a CGM? Who qualifies, step by step
The five Medicare rules in plain words. How you can qualify without insulin. And the visit you need every six months to keep it.
Written by PlanScout teamReviewed by PlanScout Internal Review TeamLast reviewed Oct 25, 20263 sourcesHow we make money
The five rules
- You have diabetes.[1]
- Your doctor decides that you, or the person who helps you, know how to use the device. Writing the order shows this.[1]
- The device is ordered for a use its maker's government approval allows. That includes the ages it is approved for.[1]
- You use insulin, or you have a history of serious low blood sugar.[1]
- Your doctor saw you in person or by an approved video visit within six months before the order.[1]
If you don't use insulin
- You can still qualify through the low blood sugar path. Insulin is one way in, not the only way.[1]
- Your records must show more than one low below 54 that kept happening after your care plan was changed more than once.[1]
- Or they must show one severe low below 54 where you needed someone else's help to treat it.[1]
Keeping your coverage
- Every six months, your doctor must see you in person or by video. The visit notes that you are using the device and following your plan.[1]
- If a rule is not met, Medicare denies both the device and the monthly supplies.[1]
Step by step
- Book a visit with the doctor who treats your diabetes. Ask if a CGM fits your care.[1]
- If you don't use insulin, ask the doctor to note any serious lows in your record.[1]
- Your doctor sends the order to a supplier that is enrolled in Medicare.[2]
- The supplier checks the rules, then ships the device and your first supplies.[3]
- Put a visit on your calendar every six months so your coverage keeps going.[1]
Prices and suppliers near you
Enter your ZIP code in the price box above to see how many suppliers near you billed Medicare for CGM. Or search suppliers by ZIP.
More in this guide
- Continuous glucose monitors: overviewHow a glucose monitor works and who Medicare covers. See what you pay in your ZIP code. Then see how Dexcom, Libre, MiniMed and Eversense differ.
- What a CGM costs with MedicareWhat you pay with Original Medicare. What the monthly supply payment buys. And why using only your phone can cost you.
- How to get a CGM, and how to switch brandsWho writes the order, how to pick a supplier, what training to expect, and what to know before you switch to another CGM brand.
- Living with a CGM: phones, accuracy, travel and fixesHow readings reach your phone or reader, what accuracy numbers mean, airport screening, medical scans and what to do when a sensor fails.
Reviewed & sourced
- Reviewer
- PlanScout Internal Review Team. Checks facts and plain-English accuracy; has no say in how results are ordered.
- What was checked
- Owner sign-off for the PlanScout Internal Review Team: Medicare coverage rules, costs and brand facts against the cited sources
- Last reviewed
- Oct 25, 2026
- Next review
- Before Jan 1, 2027 (new plan year), or sooner if Medicare changes a rule.
- Corrections
- See something wrong? Tell us. We fix confirmed errors within 2 business days and note the change in the page's change log.
- Change log
- Oct 25, 2026: First published and reviewed.
Sources (3)
- Medicare Coverage Database: Glucose Monitors, LCD L33822 (revision effective 10/01/2024) (retrieved Oct 25, 2026)
- Medicare.gov: Continuous glucose monitors (retrieved Oct 25, 2026)
- Medicare Coverage Database: Glucose Monitor Policy Article A52464 (revision effective 02/18/2025) (retrieved Oct 25, 2026)