Does Medicare Cover a CGM? (The Rule Changed)

If you were told “no” in the past, read this — because the answer may have changed.

The big change

Medicare Part B covers continuous glucose monitors (CGMs), and in 2023 the rules expanded dramatically. The old requirement that you take multiple insulin injections per day is gone. Today, any insulin use — any type, any amount — can qualify you. Even some people who don’t take insulin qualify, if they have a documented history of serious low-blood-sugar episodes.

What you need

• A diagnosis of diabetes, and either insulin use (any dose) or documented problem hypoglycemia
• A visit with your provider — in person or by telehealth — within six months before the order
• An FDA-approved CGM prescribed by your provider

Where people get stuck

The six-month visit requirement is where most denials happen now. If it’s been longer than six months since your provider documented your diabetes care, the order can bounce — not because you don’t qualify, but because the paperwork clock ran out. The fix is usually as simple as a telehealth visit.

What it costs

Under Part B, you typically pay a share of the cost after your deductible — and many Medicare Advantage and supplement plans cover some or all of that share. This is exactly the kind of detail worth checking on your specific plan.