The Dexcom G5 was the first to obtain that status and be known as a therapeutic CGM, followed by the Abbott FreeStyle Libre and then Eversense 90-day implantable CGM. That so-called “dosing claim” was a new category created by the Food and Drug Administration (FDA), its first attempt to distinguish the different levels of CGM technology that existed at that time in 2017. But Medtronic is the only company that did not get a “non-adjunctive” designation, which would’ve allowed the CGM to be used for insulin dosing and treatment decisions without a need for confirmatory fingersticks. The other CGM products available - Dexcom G5 and G6, Abbott FreeStyle Libre 2, and the implantable Eversense CGM from Senseonics and Ascensia - have been covered for years. Up until now, Medtronic has been the only CGM company without Medicare coverage. Why Medicare will cover the Medtronic CGM now With access and affordability often the biggest hurdle to achieving better health outcomes, Medicare policy changes are key, as the federal insurance program typically leads the way on what coverage will be provided by private health insurers. George Grunberger, a well-known endocrinologist and healthcare advocate in Michigan. “It was about time to make these stupid barriers go away permanently, after it was sort of suspended due to the pandemic,” said Dr. The new policy also allows Medicare members to get coverage for both CGM use as well as a newer form of inhaled insulin called Afrezza, changing the wording from “injection” to “administration” to allow for coverage of this insulin to be included. This latest rule follows a new Medicare policy that took effect in July 2021, doing away with a longstanding requirement that before any beneficiary could get approved for a CGM, they would need to provide a blood sugar log showing 4 or more tests a day using a traditional fingerstick glucose meter. The Centers for Medicare & Medicaid Services (CMS) announced a new final rule on this in December 2021, finalizing a proposal first pitched a year earlier in 2020. 28, 2022, those using a Medtronic CGM integrated with the company’s MiniMed insulin pumps will be able to get Medicare coverage for their transmitters, sensors and supplies. This is a big-ticket item, given that one-third of Medicare’s roughly 62 million beneficiaries live with diabetes and more are being directed to CGM as a way to help manage their condition better than with traditional fingerstick tests, that only take a single reading at a time.īeginning Feb. Medicare has expanded access and removed major barriers to allowing people with diabetes (PWDs) to use continuous glucose monitor (CGM) devices, the most powerful technology currently available for regulating blood sugar levels. Share on Pinterest Image via Medtronic Diabetes

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