How to Get a CGM Through Medicare — Step-by-Step Guide

Hello. Getting a continuous glucose monitor covered by Medicare involves a few steps, but most people find the process straightforward once they know what to expect. Here is the complete process from start to finish. Step 1: Talk to your doctor and confirm you are eligible. Schedule an appointment — or use your next scheduled diabetes visit — to discuss CGM. Tell your doctor you would like to start CGM and ask them to check whether your chart documents your diabetes diagnosis, insulin regimen, and testing frequency. Ask specifically about the Dexcom G7, FreeStyle Libre 3, or Medtronic Guardian 4, as these are the current devices covered as therapeutic CGMs under Medicare Part B. Step 2: Get a written prescription from your doctor. Your doctor writes a CGM prescription that specifies the device brand and model, the number of sensors needed per month, and includes a diagnosis code for diabetes. Ask your doctor to also write a Certificate of Medical Necessity for DME — this is a form your DME supplier will use to bill Medicare. Step 3: Choose a Medicare-enrolled DME supplier. Your CGM sensors and receiver must be ordered through a DME supplier that accepts Medicare assignment. You can use the Medicare Supplier Directory at medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to find suppliers near you. Some CGM manufacturers — including Dexcom and Abbott — have programs to help connect you with enrolled DME suppliers. Step 4: Submit your prescription and insurance information to the supplier. The DME supplier will collect your Medicare number, your secondary insurance information, your doctor's prescription and contact information, and often your medical records showing the face-to-face visit within 6 months. Gather these documents before calling the supplier to speed up the process. Step 5: Wait for prior authorization if your plan requires it. Some Medicare Advantage plans require prior authorization before approving CGM coverage. Your DME supplier typically handles this on your behalf, but the process can take 3 to 10 business days. Original Medicare Part B generally does not require prior authorization for therapeutic CGMs, but documentation must be complete. Step 6: Receive and set up your CGM starter kit. Your DME supplier ships the CGM receiver or transmitter and your first month of sensors directly to your home. The box includes the device, sensors, applicator, quick-start guide, and documentation. Most manufacturers also offer free phone or video setup support — Dexcom, Abbott, and Medtronic all have dedicated onboarding teams. Step 7: Schedule ongoing supply deliveries. Once enrolled with a DME supplier, you receive monthly or quarterly sensor shipments automatically. Your DME supplier should contact you before each shipment to confirm. Keep your insurance information current — if your Medicare plan changes, notify your supplier immediately to avoid billing interruptions. Step 8: Know what you pay. Under Original Medicare Part B, you pay 20% of the Medicare-approved amount after your annual Part B deductible ($240 in 2024). A Medicare Supplement policy typically covers this 20%. If you are in a Medicare Advantage plan, your plan's copay schedule applies — check your plan's DME benefit before ordering. Step 9: If your claim is denied — appeal. Medicare CGM denials often occur because documentation was incomplete, not because you are ineligible. Your DME supplier can help you gather the required documentation and file an appeal. Most denials related to documentation are overturned on first appeal. Still need help? Find a CGM provider near you →