For those like myself, with uncontrollable or severe diabetes Continoues Glucose Monitoring Systems are available and now covered by Medicare.
Generally Medicare requires you pay a 20% co-pay. The Freestyle Libre which I personally use was obtained from a durable medical supply company which picked up the remaining 20%. Abbot laboratory the manufacturer of the freestyle Libre contracts with 4 durable supply companies approved by Medicare, this is the only way Medicare will pay. The will not pay through a traditional brick and mortar retailer such as CVS, Wal-Mart, Walgreens etc.
So far my experience with the freestyle Libre has been mixed. It’s certainly very convenient and easy to use however sensors sometimes fail and it’s been inaccurate up to 60 points at times. Nevertheless, while disappointed somewhat it’s certainly an upgrade from finger sticks.
Both systems are covered for people on intensive insulin therapy (multiple daily injections or insulin pump), assuming they meet the other criteria listed below – this includes both type 1 and type 2 diabetes. In a huge plus, neither CGM requires fingerstick calibration.
The updated version of FreeStyle Libre reduces the warmup time to one hour (down from 12 hours) and extends the wear time to 14 days (up from 10 days).
Dexcom G6 had outstanding accuracy with no fingersticks, the less painful and much simpler one-button inserter, and the slimmer transmitter. Current Dexcom G5 users on Medicare will be contacted to move to the G6 once their G5 transmitter expires. New Dexcom users should transition from the G5 now, since the Medicare shipments have begun. I am not sure if Dexcom’s G6 for Medicare will ship with a bundled Ascensia Contour glucose meter/strips, like it currently does for the G5; it’s possible this will be excluded, since the G6 does not need fingerstick calibration.
As a reminder, Medicare now covers CGM use with smartphone apps, meaning Medicare beneficiaries can use the G6 and obtain real-time readings directly on an iPhone or Android with the paired app. Abbott’s FreeStyle LibreLink app is also available at the Google play store.
Comparison-wise, these are both great systems with some important differences. FreeStyle Libre 14-day has slightly longer wear and a shorter one-hour warmup time vs. G6’s 10-day wear and two-hour warmup. The G6 has the benefit of low/high glucose alarms, continuous data sent to Apple and Android apps, and remote monitoring for caregivers. FreeStyle Libre still requires a manual scan to view a real-time glucose value, while the G6 sends the data direct to the receiver/app via Bluetooth. For those with hypoglycemia concerns, the G6 may be a better bet. For those desiring a simpler or longer-wear system, FreeStyle Libre 14-day may be preferred.
The price of CGM remains the same under Medicare, with beneficiaries usually paying 20% of the cost out of pocket (roughly $50/month, though this can vary).
The eligibility criteria to get CGM covered by Medicare also remain the same:
- Uses a home blood glucose monitor (BGM) and performing four or more BGM tests per day
- On multiple daily injections of insulin or an insulin pump
- Insulin treatment regimen requires frequent adjustment on the basis of CGM
- In the six months prior to ordering the CGM, must have an in-person visit with the treating healthcare provider to determine the above criteria are met
- Every six months following the prescription of the CGM, must have in-person visits with the treating healthcare provider to assess
For people like myself who stick at least 4 times my fingers are grateful for the CGM Systems.