{"id":637365,"date":"2026-11-09T09:00:35","date_gmt":"2026-11-09T14:00:35","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=637365"},"modified":"2026-10-27T14:41:45","modified_gmt":"2026-10-27T18:41:45","slug":"does-medicare-cover-dexcom","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-dexcom\/","title":{"rendered":"Does Medicare cover Dexcom? What changed in 2026"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/dexcom-g7-sensor\">Dexcom<\/a> sells three continuous glucose monitors (CGMs) to help people monitor their blood sugar levels. Two of these devices, the Dexcom G6 and G7, are designed to alert people with diabetes when their <a href=\"https:\/\/www.singlecare.com\/blog\/blood-sugar-chart\/\">blood sugar gets too high or too low<\/a>. The <a href=\"https:\/\/www.singlecare.com\/prescription\/dexcom-g6-sensor\/what-is\">Dexcom G6<\/a> was discontinued in July 2026. However, it remains available for purchase while supplies last. G6 users are encouraged to <a href=\"https:\/\/www.singlecare.com\/blog\/switching-from-dexcom-g6-to-g7\/\">upgrade to G7<\/a>. The over-the-counter device, Dexcom Stelo, doesn\u2019t feature an alarm and isn\u2019t designed for people who take insulin or experience low blood sugar episodes (hypoglycemia).<\/p>\n<p>Because they\u2019re considered durable medical equipment (DME), Dexcom G6 and Dexcom G7 are covered under Medicare Part B. However, having a diabetes diagnosis doesn\u2019t guarantee coverage. While there are rumors about expanded Medicare coverage for Dexcom, coverage hasn\u2019t changed in 2026.<\/p>\n<h2 id=\"who-qualifies-for-dexcom-coverage-under-medicare\">Who qualifies for Dexcom coverage under Medicare?<\/h2>\n<p>Medicare Part B covers Dexcom CGMs for people who meet certain <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/lcd.aspx?lcdid=33822\">eligibility criteria<\/a>. All of the following must be true:<\/p>\n<ul>\n<li>You have <a href=\"https:\/\/www.singlecare.com\/conditions\/diabetes-causes\">diabetes mellitus<\/a> (Type 1 diabetes, Type 2 diabetes, or gestational diabetes).<\/li>\n<li>Your healthcare provider must confirm that you or a caregiver has been sufficiently trained in using a therapeutic CGM.<\/li>\n<li>The CGM must be prescribed according to its FDA-approved indications. For example, a 10-day Dexcom is approved for people 2 years and older, while a 15-day system is approved for adults 18 years and older.<\/li>\n<li>You must take insulin or have a history of problematic hypoglycemia, defined as two or more Level 2 hypoglycemic events (where your blood sugar falls below 54 milligrams per deciliter) or one Level 3 hypoglycemic event (where you lose the physical or mental ability to administer your own treatment).<\/li>\n<li>You must have an in-person or Medicare-approved telehealth appointment with your prescriber at least six months prior to getting a CGM. These appointments must be repeated every six months to maintain coverage.<\/li>\n<\/ul>\n<p>Medicare may stop covering Dexcom if you no longer meet these requirements.<\/p>\n<h3 id=\"does-medicare-cover-dexcom-for-type-2-diabetes\">Does Medicare cover Dexcom for Type 2 diabetes?<\/h3>\n<p>Yes, Medicare covers Dexcom for Type 2 diabetes. However, a Type 2 diabetes diagnosis isn\u2019t enough to get Medicare coverage for Dexcom. You\u2019ll also need to take insulin or have a history of certain serious or severe low blood sugar episodes.<\/p>\n<h2 id=\"what-actually-changed-for-dexcom-and-medicare-in-2026\">What actually changed for Dexcom and Medicare in 2026<\/h2>\n<p>So far, nothing has changed in terms of Dexcom Medicare coverage in 2026. However, experts anticipate cost and eligibility changes over the next couple of years.<\/p>\n<h3 id=\"changes-to-cost-and-supply-model\">Changes to cost and supply model<\/h3>\n<p>Medicare beneficiaries may also see some changes in the cost of Dexcom.<\/p>\n<p>The CMS operates the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP), which allows suppliers to periodically bid for the ability to furnish DME to Medicare recipients. The <a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/durable-medical-equipment-prosthetics-orthotics-supplies-competitive-bidding-program-updates\">next bidding cycle<\/a> opens in late 2026, and CGM suppliers are allowed to participate for the first time. While the bid results won\u2019t change anything for beneficiaries until early 2028, the bidding process is expected to lower the cost of CGMs like Dexcom.<\/p>\n<p>The CMS also announced that it will be changing CGMs to a rental payment model starting Jan. 1, 2028. \u201cIn general, once this national program starts, CGM devices, supplies, and accessories will all be included in one payment,\u201d explains <a href=\"https:\/\/agapetc.com\/contributors\/charles-l-smith\/\">Charles Smith<\/a>, DO, medical director of Agape in Fort Lauderdale, Florida. \u201cAdditionally, Medicare recipients will be required to get their CGM and supplies from Medicare-contracted suppliers.\u201d<\/p>\n<p>Dexcom must go through the bidding process to become a Medicare-contracted DME supplier. Because Dexcom is a leading CGM company already supplying devices to millions of Medicare recipients, it\u2019s highly likely to be awarded a contract. However, there are no guarantees. In the event that you would have to switch suppliers in 2028, Medicare will offer a six-month transition period to ensure no gaps in coverage.<\/p>\n<h2 id=\"which-dexcom-models-does-medicare-cover\">Which Dexcom models does Medicare cover?<\/h2>\n<p>Medicare covers the Dexcom G6 and G7 (both the 10-day and the 15-day). The over-the-counter Dexcom Stelo isn\u2019t covered.<\/p>\n<h2 id=\"how-much-will-you-pay-for-dexcom-with-medicare\">How much will you pay for Dexcom with Medicare?<\/h2>\n<p>The <a href=\"https:\/\/www.singlecare.com\/blog\/dexcom-g7-cost-per-month\/\">cost of Dexcom<\/a> with Medicare can vary slightly based on whether you have Original Medicare (Part A and Part B, with or without a Medigap) or Medicare Advantage (Part C).<\/p>\n<p>With Original Medicare, Dexcom is covered under Part B. You need to meet the Part B deductible before Medicare starts assisting with payments. Everyone with Medicare Part B pays the same deductible, which is around $280. The deductible increases slightly each year. If you have a Medigap, coverage of the deductible may be a covered benefit.<\/p>\n<p>After reaching that deductible, Medicare covers 80% of the cost of Dexcom. You pay the other 20%. A one-month supply of Dexcom sensors costs about $567 on average, so you might pay about $113 with Medicare Part B\u2014again, unless you have a supplemental plan like a Medigap.<\/p>\n<p>You might pay a different amount for Dexcom if you have Medicare Part C. These plans can set their own coinsurance rates or copays, and they often have higher deductibles. Check your plan\u2019s Summary of Benefits document to confirm the cost of Dexcom with Medicare Part C.<\/p>\n<h2 id=\"what-to-do-if-medicare-doesn-t-cover-your-dexcom\">What to do if Medicare doesn&#8217;t cover your Dexcom?<\/h2>\n<p>If Medicare won\u2019t cover your Dexcom, call the customer service number on your health insurance card to find out why. There may be a simple, fixable reason why coverage was denied, such as missing the six-month appointment requirement. You can also talk to your healthcare provider about appealing the decision.<\/p>\n<p>If Medicare won\u2019t cover Dexcom because you don\u2019t use insulin or meet other eligibility criteria, talk to your healthcare provider about other options.<\/p>\n<p>\u201cIt may be worth checking to see if other types of monitors might be covered if a person with Type 2 diabetes [wants] to make short-term treatment decisions,\u201d says <a href=\"https:\/\/parkavendo.com\/meet-our-team\/gillian-goddard-m-d\/\">Gillian Goddard<\/a>, MD, board-certified endocrinologist and author of <i>The Hormone Loop<\/i>. For example, Medicare covers blood glucose meters (BGMs) for people who have diabetes and have been trained to use fingersticks.<\/p>\n<p>\u201cBut if a person is controlling their blood sugar with diet or medications that don&#8217;t cause low blood sugars, like metformin or a GLP-1, they probably don&#8217;t need to monitor their blood sugar at home,\u201d Dr. Goddard adds.<\/p>\n<p>You can also pay out of pocket for Dexcom if your healthcare provider prescribes it. A SingleCare prescription discount card can lower the cost of Dexcom for self-payers. You can get three 10-day <a href=\"https:\/\/www.singlecare.com\/prescription\/dexcom-g7-sensor\">Dexcom G7 sensors<\/a> (a one-month supply) for about $357 just by showing your pharmacist a SingleCare coupon at checkout.<\/p>\n<h2 id=\"frequently-asked-questions\">Frequently asked questions<\/h2>\n<h3 id=\"does-medicaid-cover-dexcom-too\">Does Medicaid cover Dexcom too?<\/h3>\n<p>Every state operates its own Medicaid program, so Medicaid coverage for Dexcom varies by state. Contact your state\u2019s Medicaid office to learn about coverage and eligibility requirements.<\/p>\n<h3 id=\"how-much-does-medicare-pay-toward-a-dexcom-g6-or-g7-sensor\">How much does Medicare pay toward a Dexcom G6 or G7 sensor?<\/h3>\n<p>The exact cost-sharing structure for Dexcom G6 or G7 sensors varies by plan. If you have Original Medicare (Part A and Part B), Medicare covers 80% of the cost of Dexcom before any supplemental plan like a Medigap pays. If you have a Medicare Advantage plan (Part C), cost-sharing varies.<\/p>\n<h3 id=\"does-medicare-cover-the-dexcom-stelo-the-over-the-counter-cgm\">Does Medicare cover the Dexcom Stelo, the over-the-counter CGM?<\/h3>\n<p>No, Medicare doesn\u2019t cover the Dexcom Stelo.<\/p>\n<h3 id=\"do-you-need-a-prescription-for-a-dexcom-if-you-have-medicare\">Do you need a prescription for a Dexcom if you have Medicare?<\/h3>\n<p>Yes, you need a prescription for Dexcom G6 and G7 if you have Medicare. Dexcom Stelo doesn\u2019t require a prescription because it\u2019s available over the counter, but it\u2019s not covered by Medicare.<\/p>\n<h3 id=\"does-medicare-advantage-cover-dexcom-the-same-way-original-medicare-does\">Does Medicare Advantage cover Dexcom the same way Original Medicare does?<\/h3>\n<p>Medicare Advantage and Original Medicare use the same eligibility criteria to determine coverage for Dexcom. The only difference is in how much you might pay out-of-pocket for Dexcom with Original Medicare versus. Medicare Advantage.<\/p>\n<h2 id=\"the-bottom-line\">The bottom line<\/h2>\n<p>Although Dexcom is covered by Medicare, many people don\u2019t realize that insulin use is required for coverage. That may change in the near future, but no changes to Dexcom coverage have officially been announced for 2026. In the meantime, a SingleCare coupon can help lower out-of-pocket expenses for people who could benefit from Dexcom but don\u2019t meet Medicare coverage criteria.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dexcom sells three continuous glucose monitors (CGMs) to help people monitor their blood sugar levels. Two of these devices, the Dexcom G6 and G7, are designed to alert people with diabetes when their blood sugar gets too high or too low. The Dexcom G6 was discontinued in July 2026. However, it remains available for purchase [&hellip;]<\/p>\n","protected":false},"author":135,"featured_media":637133,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[],"coauthors":[21074],"class_list":["post-637365","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.6 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Medicare cover Dexcom? 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