{"id":1977,"date":"2022-09-07T14:29:59","date_gmt":"2022-09-07T21:29:59","guid":{"rendered":"https:\/\/joinbetter.com\/community\/blog\/?p=1977"},"modified":"2022-10-05T15:28:19","modified_gmt":"2022-10-05T22:28:19","slug":"cgm-and-insurance-are-you-covered","status":"publish","type":"post","link":"https:\/\/joinbetter.com\/community\/blog\/diabetes\/cgm-and-insurance-are-you-covered\/","title":{"rendered":"CGM and Insurance: Are You Covered?"},"content":{"rendered":"\n

A Continuous Glucose Monitor (CGM) is a complementary device for managing type 1 or 2 diabetes. For patients with diabetes, a CGM may lessen the frequency of finger-stick tests and let them see their glucose trends conveniently. Additionally, people with poorly controlled type 2 diabetes can significantly lower their blood sugar levels with this device. But despite its usefulness, it may be challenging to acquire.<\/p>\n\n\n\n

If you live paycheck to paycheck or have other financial priorities, this medical product may not fit your budget. But depending on factors such as brand and insurance, getting a CGM is still possible. Learning about the costs involved in getting a continuous monitoring device might be difficult, but it\u2019s essential for you to understand the details so that you can minimize your expenses.<\/p>\n\n\n

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How much does a CGM cost?<\/h2>\n\n\n\n

Like any other diabetes product, CGM prices may vary depending on the brand and the way it works. Many insurers cover CGMs for people with diabetes, especially if you are on insulin and meet their guidelines. Without insurance, CGMs may cost more than you are able to spend, but for some people, may be worth the cost. <\/p>\n\n\n\n

To lessen your out-of-pocket expenses, check with your insurance to see if they cover some of the cost. <\/p>\n\n\n\n

Where can you get information about CGM insurance?<\/h3>\n\n\n\n

The best way to see if your insurance company covers CGM  is by asking the right people. It might be hard to work your way through all the rules and terms, but reaching out to people who know the answers can give you the necessary information. Here are some ways you can get answers:<\/p>\n\n\n\n

Better Health<\/h3>\n\n\n\n

Better Health<\/a> can help you with the time-consuming task of figuring out if your insurance covers a CGM and your other diabetes supplies.  A member care advisor can check for insurance coverage, and even coordinate with your doctor on your prescription \u2013 all at no cost.  They can even help you select the right product, and ship it directly to you for free. Visit their website or call 415-475-8444<\/a> for assistance.    <\/p>\n\n\n\n

Your employer\u2019s benefits manager<\/h3>\n\n\n\n

If you get your healthcare insurance through your employer, you may ask your human resources manager or a third party who acts as an internal benefits manager about their coverage for CGMs. They can give you more information about your insurance plan or point you to the right person.<\/p>\n\n\n\n

Your insurance company<\/h3>\n\n\n\n

Most insurers also have a website where you can search for your plan. There, you can search out if they cover CGMs. Coverage details may also differ from one insurance company to another, so you might find the CGMs in a section you weren\u2019t expecting. <\/p>\n\n\n\n

For example, one insurance website may say \u201cnot covered\u201d when you search CGMs under pharmacy benefits. But if you look more, you might find the device under the durable medical equipment (DME) benefits. Try to spend time looking at different options in your insurance researching different plans to make sure that you cover all bases.<\/p>\n\n\n\n

Another way to figure out your coverage is to contact your health insurance carrier. You can look for the company\u2019s phone number on their website or your membership card.<\/p>\n\n\n\n

When you have their contact information, a good rule of thumb is to set aside 30 minutes of your time for a call with a customer service representative. They can explain the coverage of your insurance plan, which may include CGMs.<\/p>\n\n\n\n

How will you know if you can get CGM insurance?<\/h2>\n\n\n\n

You must first ask yourself whether you are eligible before applying for CGM insurance. Most insurers provide criteria you should meet, including:<\/p>\n\n\n\n

A diagnosis of type 1 diabetes<\/h3>\n\n\n\n