Dexcom G7 is a real-time CGM system that sends glucose numbers to your Dexcom receiver and smartphone* without fingersticks. Scanning the flash reader is painless and can be done several times a day. The Dexcom G6 is a game-changer for people with diabetes, and we are thrilled to provide this innovative technology to the many Americans with diabetes who rely on Medicare, said Kevin Sayer, President and CEO of Dexcom. If your patients currently use Dexcom G6 with a connected insulin pump, we recommend continuing it until Dexcom G7 adds compatibility with your pump or pen. These videos can walk you through the steps to get started, including receiver and app set-up, and downloading Dexcom Clarity. 2021 MedicareTalk.netContact us: [emailprotected], Dexcom G6 Dexcom New Me Medicare Testimonial, Dexcom G6 Coverage for Medicare Patients on Mealtime Insulin, When Is The Enrollment Period For Medicare Part D, Does Southeastern Spine Institute Accept Medicare, How Do I Apply For Medicare Part A Online, Do I Have To Re Enroll In Medicare Every Year, Does Medicare Part B Cover Freestyle Libre Sensors, Does Medicare Require A Referral For A Colonoscopy, Abbott Diabetes Cares FreeStyle Libre Flash Glucose Monitoring System, How Does Medicare Work With Other Insurance, Does Medicare Pay For Radiation Treatments, How Do I Know If I Have Original Medicare, How Much Does Medicare Part B Cost For A Couple, Which Medicare Advantage Plans Cover Massage Therapy, Does Medicare Help Pay For Incontinence Supplies, How Do I Get A New Medicare Health Insurance Card, How Much Of Cataract Surgery Does Medicare Cover, Medicare Part B covers blood glucose testing and other supplies you may need, plus some medical and education services, Medicare Part D covers diabetes medications and supplies for injecting or inhaling insulin. Visitwww.dexcom.com/medicareto view online training videos. Hopefully the Dexcom-Walgreens partnership will be successful but I suspect it will take a while to work seamlessly. Many Medicare beneficiaries have supplemental insurance coverage such as Medigap that covers their out-of-pocket costs. Medicare will only cover a CGM if the FDA has approved the CGM for use in diabetes treatment decisions or if it is FDA approved and pairs with an insulin pump. Walgreens is licensed to dispense Part B DME for Medicare because that is how they have for many years provided test strips, insulin for pumps, and other DME products. For technical troubleshooting, our specialists are available 24/7 at 844-607-8398. These blood glucose monitors automatically track blood glucose levels, or blood sugar. If you are a current Dexcom G6 user not on a connected insulin pump, please speak to your doctor about getting a prescription for Dexcom G7. Medicare covers Dexcom CGM for insulin-requiring patients who meet the Medicare coverage criteria. Smart device sold separately.. 2021;325(22):2262-2272. Today, Donna takes pride in providing outstanding customer service and going the extra mile to make sure each client knows all of their options and has a sound understanding of their Medicare plan, from costs to coverage and all points in between. Your patients may call a distributor from the list below to start the ordering process. People covered by Medicare who have either Type 1 or Type 2 diabetes and intensively manage their insulin are able to obtain reimbursement for the Dexcom G6. Dexcom has a discounted receiver program through GoodRx for getting a G7 receiver at an affordable price. 8 Miller KM, et al. The Dexcom G6 Continuous Glucose Monitoring (CGM) System is indicated for ages 2 years and older. To ensure a successful transaction, please confirm your submitted First Name and Last Name match that associated wtih your NPI number. If your patient uses a connected insulin pump or pen, we recommend they continue using Dexcom G6 until our insulin delivery partners integrate with Dexcom G7. 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. What Medical Equipment Does Medicare Pay For? There is a lot of discussion on social media this week about Dexcom G6 finally being available for Medicare recipients. Using a Dexcom CGM System is proven to lower A1C and help you spend more time in range, Dexcom CGM Systems are covered by Medicare. As with most other technology, diabetes technology continues to evolve, and newer products have since followed suit, including those manufactured by Abbott, Medtronic, and others. All the details of putting that new policy into place were laid out for Medicare contract companies in a comprehensive Local Coverage Determination document. . Even those who are not on insulin, but experience low blood glucose events, can qualify for Dexcom CGM coverage. For technical troubleshooting, our specialists are available 24/7 at 844-607-8398. Can't find the answer you're looking for? BRIEF SAFETY STATEMENT: Failure to use the Dexcom Continuous Glucose Monitoring System and its components according to the instructions for use provided with your device and available at https://www.dexcom.com/safety-information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. Dexcom's newest CGM, the G6, is currently under Medicare review and a decision is expected this fall. Generally, Medicare patients pay 20% out of pocket. Original Medicare and many Medicare Advantage plans cover continuous glucose monitors such as the FreeStyle Libre systems and Dexcom G6. The Continue link below will take you out of the Abbott Laboratories family of websites. A Non-Government Resource For Healthcare All Rights Reserved 2023. Start Your Order Dexcom G6 Description The Dexcom G6 CGM System can help make glucose testing a breeze! Ahmann agrees that the Dexcom might be preferred by patients who have hypoglycemic episodes: If you want the most data, you would certainly want the Dexcom platform because it provides more information and has the alarms. CGM supplies and accessories are covered by Medicare when the beneficiary uses a receiver classified as DME to display glucose data. They are easy to wear and use. Healthline Media does not provide medical advice, diagnosis, or treatment. You have an in-person or Medicare-approved visit with the practitioner who prescribed the CGM every 6 months after initiating CGM therapy, General customer support MondayFriday 6:00 am5:00 pm PST, Product troubleshooting inquiries 24 hours a day, 7 days a week. DiabetesMine explores how long a person with diabetes can live without insulin, and how they can prolong life. New Patients: Get Started with Dexcom CGM. This Medicare coverage update for app use will include G6, if it becomes covered. Prescribing Info Dexcom G6 CGM Pharmacy Ordering and Filling Info Sheet The Dexcom G6 CGM is Available Through Pharmacy! Read Also: How Do I Get A New Medicare Health Insurance Card. We feel very strongly that others at risk of hypoglycemia, especially those on sulfonylureas , should also have access to CGM. Longtime diabetes advocate George Huntley, who lives with T1D himself and serves as CEO of the Diabetes Leadership Council, told DiabetesMine: We applaud this decision, but it is only the first step. Advanced Diabetes Supply has specialized and created a unique expertise in working with Medicare patients and beneficiaries. When asked, enter the SN (serial number) of the transmitter you're wearing. Additionally, the medical record must contain at least two previous medication adjustments or changes to the treatment plan (such as raising A1C targets) prior to the most recent Level 2 event. Receiver is required to be used along with smart device in order to receive Medicare benefits for CGM. . This allows the canula to measure glucose readings in the interstitial fluid, which is fluid that surrounds the cells. You must visit, in-person or via telehealth, with the treating practitioner every six months to assess how well you are following your CGM treatment plan. Redetermination for Medicaid | What to Know in 2023. Who Is Eligible for Medicare Part B Premium Reimbursement? The Dexcom G6 Continuous Glucose Monitoring (CGM) System is now available to more of your eligible Medicare patients with Type 1 or Type 2 diabetes. Introducing some of the most popular diabetes lancing devices, with comparative product details. The Dexcom G6 and G7 Continuous Glucose Monitoring (CGM) Systems are covered by Medicare for patients who meet the Medicare coverage criteria. With new expanded coverage, Medicare now covers Dexcom CGM for people with diabetes who are on any type of insulin. 2017;317(4):371-378. information and promotional communications related to Dexcom products. Home / Products / Continuous Glucose Monitoring (CGM) / Dexcom G6 Smart device not included Dexcom G6 may be covered by your insurance/Medicare. The simple applicator will allow the Dexcom G6 transmitters small canula to be inserted under the skin. Your patients may call a distributor from the list below to start the ordering process. including of a copy of your BGM testing log into the medical record. The agency found no evidence that more fingerstick checks led to better health outcomes, compared with lower frequency testing. There arent any changes to CGM payment rates or billing requirements under Medicare. The beneficiary must simply be insulin-treated. How do new Medicare customers get a Dexcom CGM? The Freestyle Libre is a little simpler for the older patient or others who arent as comfortable with the technology. Mike Hoskins of Healthline shares his experience using Tandem's Control-IQ system, which partially automates insulin delivery. 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. It is also easy enough to use that I can walk her through the setup process over the phone, which is useful since she is elderly with some memory issues.. Insulet's Omnipod 5 becomes the first commercially available Automated Insulin Delivery (AID) system with no tubes and smartphone control. How do I use my smart device to see my readings? Visitwww.dexcom.com/medicareto view online training videos. Before the Medicare coverage, a typical patient would spend $2500 to $4000 a year, Sayer says. Medicare or Medicaid patients who use Guardian Connect and do not have coverage are eligible for the CGM Access Discount program, which offers patients transmitters and sensors at a lower cost. For Medicare coverage of Continuous Glucose Monitoring (CGM), CMS requires use of a receiver. But this policy change requested by Afrezza-maker MannKind Corp. amended the definition to include someone taking an inhaled insulin as an alternative. Under Medicares DME fee schedule, reimbursement for CGMs, using CPT codes K0554 and K0553, is the same, regardless of CGM brand. If your insurance doesnt cover the G7 receiver, Dexcom has a discounted receiver program through GoodRx. You can view your glucose data through the Dexcom G6 or Dexcom G7 apps, your Dexcom G6 or Dexcom G7 receiver, and the Clarity Mobile or desktop applications. An example of data being processed may be a unique identifier stored in a cookie. 2017;167(6):365-374. ABBOTT PARK, Ill. Third-party assistance may be provided by anyone (for example: caregiver, family member, or any other person). * Even those who are not on insulin, but experience hypoglycemia events, can qualify for Dexcom CGM coverage. Please note that if the patient of this pack is a Medicare beneficiary and the individual elects to continue using Dexcom G6 after this sample, the individual will need to obtain a medically necessary Dexcom receiver in order for Medicare coverage to be . As of April 2023, Medicare now covers continuous glucose monitoring (CGM) for people who are on any type of insulin. The out of pocket costs of CGM devices can be significant, much more than traditional blood glucose monitoring systems. Compatible smart devices sold separately. You can get Medicare coverage for therapeutic CGM if you: Dont use insulin but have had certain low blood sugar events, Medicare recently updated its coverage requirements for CGM. If a beneficiary intends to never use a receiver classified as DME as the display device, the supplies and accessories are not covered by Medicare. . 4 Gilbert TR, et al. For people who have preserved feeling of hypoglycemia, the Freestyle Libre is a great tool convenient and informative. In addition, I certify that I (i) am the patient referenced above or (ii) am the parent or legal guardian of the patient referenced above, and that I am at least eighteen (18) years of age. The logic was that some didnt require fingersticks so users wouldnt need reimbursement for test strips, as would other systems that still require calibration . Since A1C is a three-month average, it doesnt give insight into potentially dangerous high and low glucose variations. CGMs provide users with real-time, dynamic information about their blood glucose levels around the clock and alerts to prevent dangerous high or low glucose levels, leading to better diabetes management and ultimately improved health outcomes. According to CMS, therapeutic CGM may be covered by Medicare when all of the following criteria are met: Also Check: Which Medicare Advantage Plans Cover Massage Therapy. Frequent adjustment of insulin on the basis of CGM results is no longer required. Devices used to administer insulin including insulin pens, needles, and syringes are covered under Medicare Part D for Medicare patients with diabetes. The Dexcom G6 and Dexcom G7 are covered by Medicare if you meet their criteria. Please note: Information provided with the sample request is validated against Provider's license information. Does Medicare cover Dexcom G6 and Dexcom G7? Aleppo says that the real-time data from the Dexcom and its alerts of impending problems make it particularly suited to patients whose hypoglycemia unawareness might lead them to manage their fear of hypoglycemia by overeating, taking less insulin, being afraid of exercise, being afraid of driving, and eating unnecessary bedtime snacks to avoid overnight events. With this stated, an imbalance in glucose levels can lead to severe health consequences, so you should never make big changes to your diet or exercise routine without discussing your situation with a qualified health professional first. Medicare covers one CGM receiver every five years. com Dexcom G6: How to Insert the Sensor & Attach the Transmitter This video is a quick display of inserting the sensor with the auto applicator and attaching the transmitter for the Dexcom G6 Medicare coverage for therapeutic CGM includes certain beneficiaries who have either type 1 or type 2 diabetes and intensively manage . Dexcom, Dexcom Clarity, Dexcom Follow, Dexcom One, Dexcom Share, and any related logos and design marks are either registered trademarks or trademarks of Dexcom, Inc. in the United States and/or other countries. A patient may use a compatible smart device in conjunction with a receiver: dexcom.com/compatibility. Blood glucose monitoring (BGM) supplies are not included in the CGM product shipments because Dexcom G6 and Dexcom G7 do not require fingerstick calibrations. Dexcom G6 Medicare Patient Coverage. CGMs deliver glucose readings all day and night, which makes it easy to see glucose levels anytime, and to track changes over time, including the time spent in your target range. What is the Medicare Coverage Criteria for CGM? Video length: 1 min. For people with hypoglycemia, G6 may be a better choice. Recommended Reading: Does Medicare Require A Referral For A Colonoscopy. Get started today with the Dexcom G6 a mobile CGM system including customizable alerts that allow you to make more informed decisions about your diabetes management by providing real-time glucose readings sent right to your smart device! (Opens in a new browser tab), Does Medicare Cover Glucerna? Learn more and get a free benefits check to see if you qualify. Speak with a Licensed Medicare Sales Agent 877-388-0596 - TTY 711 (M-F 8am-9pm, Sat 8am-8pm EST | Sunday Closed), 877-388-0596 - TTY 711 (M-F 8am-9pm, Sat 8am-8pm EST | Sunday Closed). The diabetes community is celebrating a huge win! You may opt-out of these communications at any time. Your distributor will request a prescription for Dexcom G7 from your doctor and provide you with pricing and upgrade options. To qualify for Medicare coverage of your Dexcom G6 supplies, you must use a G6 receiver, even if you also use a smart device. That experience inspired Donna to focus her efforts on educating her clients to ensure they fully understand their Medicare options. I understand that I may opt out at any time by texting STOP in return to a text or by calling Dexcom at 888-738-3646, and that my consent to this contact is not required for the purchase of Dexcom products or services. Links which will take you out of Abbott Laboratories worldwide websites are not under the control of Abbott Laboratories, and Abbott Laboratories is not responsible for the contents of any such site or any further links from such site. Dexcom G6 and Dexcom G7 are available to Medicare patients through a medical distributor (see distributor list below). This is a brand name drug and a generic may be available. Medicare coverage for therapeutic CGM includes certain beneficiaries who have diabetes, are insulin-treated, and see their doctor for their diabetes every 6 months. Along with that, we carry needles and syringes in various sizes. Dexcom now ships Dexcom G6 and Dexcom G7 to Medicare patients with traditional fee-for-service coverage. To set up Dexcom Share on Dexcom G6, press the Share icon (the triangle in the upper right-hand corner of the screen) and follow the instructions. If your patients are current G6 users, please contact your distributor for pricing and upgrading options to Dexcom G7. That means that the device is so accurate, people managing Type 1 or Type 2 diabetes can dose insulin off of it. Generally, Medicare patients pay 20% out of pocket. Be insulin-treated with three or more daily administrations of insulin, or a continuous subcutaneous insulin infusion (CSII) pump, Have an insulin treatment regimen that requires frequent adjustments based on BGM or CGM testing results, Have had an in-person visit with their provider within six months prior to ordering the CGM in order to evaluate their diabetes control and determine coverage criteria is met. expensive than Dexcom G7 for A large array of private insurers in the United States cover Dexcom CGMs. Go to the App Store or Google Play store from your smart device. How Does the Dexcom G6 Work? Secondly, how much does a Dexcom CGM cost? See additional information. Diabetes care can be tricky depending on the type you have and how well you manage it. Medicare covers various diabetes medications, supplies and services to help treat diabetes and keep your blood glucose in a healthy range. If you are a current G6 patient, contact your distributor. 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