01/06/2026
MEDICARE & CGM QUESTION WE GET DAILY đ
Does Medicare Cover CGMs ? What Patients Actually Need to Qualify
If youâve been told âMedicare doesnât cover CGMs,â you were told half the story.
Medicare does cover Continuous Glucose Monitors (CGMs) like Dexcom G7 and Freestyle Libre, but only when specific requirements are met. Miss one step, and coverage stallsâor gets denied altogether.
Hereâs what actually matters.
Yes, Medicare Covers CGMsđ
Original Medicare (Part B) covers CGMs as durable medical equipment, not pharmacy items. That distinction is important because the rules are differentâand stricter.
Medicare covers CGMs for patients with diabetes who meet medical necessity criteria and have proper physician documentation.
What Medicare Requires to Qualify for a CGM
To qualify, patients generally need:
A diagnosis of diabetes
A prescribing provider actively managing the condition
Documentation showing the CGM is medically necessary
A recent face-to-face visit with the provider (in-person or approved telehealth)
Ongoing follow-up as required by Medicare
For insulin users, qualification is usually straightforward.
For non-insulin users, coverage may still be possible, but documentation must clearly support medical need.
This is where most delays happen.
The #1 Reason CGM Requests Get Denied
Itâs not the device.
Itâs not the patient.
Itâs the paperwork.
Common problems include:
Missing provider notes
Incomplete documentation
Old office visits that no longer qualify
Orders that donât match Medicare language
Medicare is very specific. One missing sentence can stop the whole process.
Libre or DexcomâDoes Medicare Care Which One?
Medicare covers both Freestyle Libre and Dexcom CGMs when criteria are met.
The âbestâ option depends on:
Physician preference
Patient lifestyle
Compatibility with readers or smartphones
Insurance guidelines
A good DME supplier helps match the patient to the right device and ensures the paperwork is correct before submission.
What Patients Should Do Next
If youâre interested in a CGM and have Medicare:
Talk with your provider about medical necessity
Make sure documentation is current and complete
Work with a supplier that understands Medicare CGM rules
Getting this right upfront saves weeks of frustration later.
At Platinum Venture Group, we help Medicare patients navigate CGM coverage, documentation, and device optionsâwithout guesswork.
đ 801-214-9918-Have questions about CGM coverage or eligibility?
Reach out to our team. Weâre here to help.