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What If Your Insurance Doesn't Cover The Dexcom, Are There Any Other Choices?

A myT1Dteam Member asked a question 💭
Brooklyn, NY
November 5
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A myT1Dteam Member

Call the Customer Service number for your insurance - - usually on the back of your insurance card - - and ask which Glucose Sensors/CGMs thry cover. There are several different sensors for sale. Some connect to a pump for automated insulin delivery (AID). If you are on a pump that works with Dexcom and your insurance doesn't cover Dex, you can apply for a Prior Authorization (PA) to get the Dexcom covered. Even without the pump, you can still request a PA.

November 11
A myT1Dteam Member

If your insurance doesn't cover the Dexcom continuous glucose monitor (CGM), here are some steps you can take:

1. Talk to Your Doctor: Discuss with your healthcare provider or endocrinologist about alternative CGMs or other diabetes management devices that might be covered by your insurance.

2. Submit an Exception Show Full Answer

If your insurance doesn't cover the Dexcom continuous glucose monitor (CGM), here are some steps you can take:

1. Talk to Your Doctor: Discuss with your healthcare provider or endocrinologist about alternative CGMs or other diabetes management devices that might be covered by your insurance.

2. Submit an Exception Request: If your doctor determines that you need the Dexcom for your diabetes management, you can work with your doctor’s office to submit an exception request to your insurance company.

3. Check the Formulary: Review your insurance policy’s formulary to see which CGMs are covered. Some insurance plans may cover other brands or generic options.

4. Appeal Denied Coverage: If your request is denied, you have the right to appeal. Contact your insurance company to understand the process and get support from your doctor to strengthen your appeal.

5. Look for Financial Assistance: Explore resources and programs that may help cover the costs of CGMs. The National Institute for Diabetes and Digestive and Kidney Diseases offers resources to help manage healthcare costs for people with type 1 diabetes.

6. Contact Manufacturers: Reach out to CGM manufacturers directly. Some may offer free devices or financial assistance programs.

By following these steps, you can explore alternative options and potentially secure coverage for a CGM that meets your needs.

November 5

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