The American Diabetes Association and diabetes patients across the country are celebrating a recent change to a Medicare requirement that delayed access to continuous glucose monitors (CGMs) for many patients with diabetes. Before July 18, 2021, Medicare patients with diabetes had to stick their fingers at least four times a day to qualify for coverage for a CGM. This requirement prevented many patients who could benefit from a CGM from access to the technology.
Advocate teams for the American Diabetes Association (ADA) worked closely with the Centers for Medicare and Medicaid Services (CMS) to remove the finger-stick requirement. The ADA has championed the removal of this requirement for many years. Considering one in five Medicare beneficiaries also have diabetes, the removal of this barrier makes a considerable difference for the community of patients with diabetes.
What is a Continuous Glucose Monitor?
A continuous glucose monitor delivers real-time, “dynamic” information about blood sugar levels to patients with diabetes. This technology has led to better management of diabetes and overall improved health outcomes.
How Newly Qualified Patients Get Coverage
Newly qualified individuals with diabetes now only need to undergo a simple, no-finger-stick approval process to get coverage for a CGM. Out-of-pocket costs depend on a variety of factors including the type of Medicare plan you have and where you choose to purchase your CGM. Talk with your healthcare provider and Medicare representative to find out what if any out-of-pocket costs you may incur.
Mantachie Rural Health Care is thrilled about new access to coverage for this groundbreaking and life-changing technology. If you are a patient with diabetes and would like to learn more about getting coverage for a CGM, contact us today to schedule a time to talk with your provider.
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