Everything You Need to Know
As of April 16, 2023, there’s incredibly exciting news from the Centers for Medicare and Medicaid Services (CMS) regarding coverage for individuals with Type 2 diabetes. Now, not only are continuous glucose monitors (CGMs) covered, but there’s something for all insulin users and those experiencing hypoglycemia as well. Brace yourself as both type 1, type 2, and even gestational diabetes programs will be included in the expanded policy. This historic change has the potential to transform the lives of millions of Americans by providing alternatives to closely monitor their blood sugar levels, leading to overall improved health. Get ready for a health revolution!
To be eligible for this exciting new Medicare CGM coverage, patients must meet certain criteria.
The patient must have diabetes mellitus and must meet at least ONE (1) of the criteria below:
Furthermore, an in-person or Medicare-approved telehealth visit with the prescribing physician is required within six months of starting CGM.
In the past, only patients using insulin treatment or a continuous subcutaneous insulin infusion (CSII) pump were eligible for CGM coverage from the CMS. However, this requirement has been lifted, allowing individuals with different Diabetes management methods to benefit from Continuous Glucose Monitors (CGM). This exciting development enables more people to gain valuable insight into their sugar levels, harness the advancements in medical technology, and lead healthier lives overall.
Physicians still need to document adherence to diabetes treatment plans and CGM device regimens, but now with fewer steps, making it more convenient for them to prescribe CGM devices. It is crucial that anyone using a CGM device follows the Food and Drug Administration’s designated indication. Adhering to these guidelines ensures exceptional patient care and positive outcomes in diabetes treatment.
Furthermore, Medicare NO LONGER requires daily testing or injection treatments to qualify for CGM coverage.
If you have Type 2 Diabetes and are enrolled in Medicare, it is crucial to take advantage of this new policy as soon as possible. Discover if you are eligible by checking your eligibility and learn more about how this policy can benefit you. If you are a Type 2 diabetic on Medicare, you don’t want to miss out on this opportunity!