April 26, 2024

Do I Need a CGM Prescription? Answers for People with Diabetes

These days, most people with diabetes have at least heard of continuous glucose monitors (CGMs). These devices allow you to test your glucose levels by simply applying a  sensor, significantly lowering your reliance on finger prick tests in the process. …

Share This Story

cgm-prescription-for-diabetes-patients-with-medicare

Home / Living with Diabetes / Do I Need a CGM Prescription? Answers for People with Diabetes

These days, most people with diabetes have at least heard of continuous glucose monitors (CGMs). These devices allow you to test your glucose levels by simply applying a  sensor, significantly lowering your reliance on finger prick tests in the process. 

Are you wondering, “Do I need a CGM prescription?” If so, you’re in the right place. Here, you’ll find US MED’s complete overview of prescription requirements for CGMs and much more information about these medical devices.

Shirley DeLeon Certified Diabetes Care & Education SpecialistWritten by: US MED Staff
Clinically Reviewed by: Shirley DeLeon, RD, CDCES

Diabetes Supplies OnlineWhat is a continuous glucose monitor (CGM)?

The term “CGM” refers to any system that provides constantly-updated glucose information to people with diabetes. Though these devices can’t totally eliminate your need for finger prick tests, they can help simplify the glucose testing process in most normal situations.

Why are CGMs used for diabetes management?

If you’ve had diabetes for long enough, you already know how inconvenient “traditional” glucose testing can be. CGMs are popular since they can significantly reduce the number of finger prick tests you’ll need to do in an average day.

However, this isn’t the only benefit these devices deliver. Since they constantly collect information, CGMs can provide a much more detailed picture of your glucose levels than traditional testing can on its own. That means you and your healthcare team can get a more accurate look at how your diabetes treatment plan is performing and closely track the effects of any changes to this plan.

How does a CGM work?

At the heart of any CGM system is a sensor, which you’ll wear on a predetermined part of your body. That sensor is responsible for collecting information on glucose levels. However, it does not measure your blood glucose directly; instead, it measures glucose readings in the fluid around your cells, AKA “interstitial fluid.” Then, that information is sent to a receiving device – either a dedicated reader or a smartphone.Some sensors require a scan in order to obtain the sensor reading.

Does a continuous glucose monitor need a prescription?

With all that out of the way, it’s time for the information you’re really looking for. Yes, you will need a CGM prescription to use a continuous glucose monitoring system. We’ll explain that in more detail below, but the key takeaway is that you won’t be able to get one of these systems without your doctor’s approval.

Who gets a CGM prescription?

Generally speaking, the FDA has approved CGMs for use by adults and children who are at least two years old. That said, age requirements may vary from one device to another.

When considering whether or not they should provide a CGM prescription, doctors tend to start by looking at a few primary factors. CGMs are often prescribed on a trial basis to patients who:

  • Are on “tight blood sugar control” – that is, intensive/high insulin therapy
  • Often have notably high or low blood glucose levels
  • Frequently experience hypoglycemia or unawareness

What is the eligibility for receiving a CGM prescription?

Other eligibility requirements for continuous glucose monitors vary by age group:

Adults with T1D and T2D

CGMs are often considered for adults with diabetes who have:

  • Blood glucose levels above 215 mg/dL more than once a day
  • A serious fear of hypos
  • Two or more hypos a week, especially if they are unusually severe or have few associated symptoms
  • Total unawareness of their hypos
  • More than one severe hypo annually, particularly if these events have no obvious trigger

Children with Juvenile Diabetes

Meanwhile, children may benefit from CGM systems if they:

  • Have trouble controlling blood sugar levels even after taking steps to manage diabetes
  • Have steroid treatments, anorexia, or other conditions that can interfere with diabetes management
  • Take part in sport-related activities
  • Experience serious diabetes complications
  • Have trouble recognizing hypo symptoms
  • Experience unawareness of hypos
  • Regularly have severe hypos

That should clarify who is and isn’t eligible for CGM systems. However, these requirements may vary by state, so double-check your local rules if you’re interested in using one of these devices.

How do I get a continuous glucose monitoring system after receiving a CGM prescription?

There are many ways to get a CGM system once you’ve received a formal prescription. That said, one of the most convenient places to order your CGM system is US MED. That’s thanks to our free priority shipping and unmatched customer service.

US MED Continuous Glucose Monitor Options

At US MED, we also pride ourselves on offering some of the best CGM systems on the market. Here are three of the products we offer in this category:

FreeStyle Libre 3 System

Pros & Cons

The FreeStyle Libre 3 represents the latest evolution in Abbott’s continuous glucose monitoring (CGM) technology, building on the solid foundation set by the FreeStyle Libre 2. Like its predecessor, the Libre 3 maintains ease of use and dependable glucose monitoring and introduces cutting-edge features designed to enhance user experience. This includes real-time smartphone readings that allow for immediate glucose updates and an even thinner sensor that minimizes discomfort.

However, as technology progresses, the FreeStyle Libre 3 may not always hold the cutting edge. Future innovations in CGM technology are expected, which could introduce new features beyond those found in the Libre 3. Nonetheless, for users who value the latest advancements in accuracy and convenience, the FreeStyle Libre 3 remains a top choice.

Cost

In line with Abbott’s commitment to affordability, the FreeStyle Libre 3 system is priced competitively, offering significant cost advantages over other CGM systems on the market.

Specs

  • Includes: FreeStyle Libre 3 reader (if used), smartphone app, USB cable, power adapter, user’s manual
  • Reader Operating Temperature: 50°F-113°F
  • Reader Power Source: Optional, as smartphone app generally used
  • Reader Size: 95 mm x 60 mm x 16 mm (if used)
  • Reader Weight: 65 g (if used)
  • Sensor Operating Temperature: 50°F-113°F
  • Sensor Power Source: Silver oxide battery
  • Sensor Reading Range: 40-500 mg/dL
  • Sensor Size: 2.4 mm height, 35 mm diameter
  • Sensor Weight: 5 g

Freestyle Libre 2 system

Pros & cons

Essentially, the FreeStyle Libre 2 system is a new-and-improved version of the FreeStyle Libre 14 day system. This product preserves the previous version’s easy-to-use, reliable§ glucose testing while adding features like optional alarms and iCGM capabilities.

The only issue is that the FreeStyle Libre 2 system won’t be at the top of the heap for much longer, either. As of mid-2022, Abbott was working to introduce its newest CGM, the FreeStyle Libre 3 system. That device, which will introduce real-time smartphone readings and ultra-thin sensors, has already received FDA clearance. But if you don’t care about those features, the FreeStyle Libre 2 is still a great choice.

Cost

Like the FreeStyle Libre 14 day system, the FreeStyle Libre 2 system’s list price is 70 percent lower than other CGM brands.¶,‡

Specs 

  • Includes: FreeStyle Libre 2 reader, USB cable, power adapter, user’s manual, additional usage guides
  • Reader Operating Temperature: 50°F-113°F
  • Reader Power Source: Lithium-ion battery (rechargeable)
  • Reader Size: 95 mm x 60 mm x 16 mm
  • Reader Weight: 65 g
  • Sensor Operating Temperature: 50°F-113°F
  • Sensor Power Source: Silver oxide battery
  • Sensor Reading Range: 40-400 mg/dL
  • Sensor Size: 5 mm height, 35 mm diameter
  • Sensor Weight: 5 g

FreeStyle Libre 2+ System

Pros & Cons

The FreeStyle Libre 2+ system is an enhanced version of the widely acclaimed FreeStyle Libre 2, maintaining all the favored features like easy-to-use, reliable glucose testing, and the addition of optional alarms and iCGM capabilities. What sets the 2+ apart is its compatibility with the t:slim X2 insulin pump, integrating glucose monitoring and insulin delivery for seamless diabetes management.

However, as technology continually advances, even the FreeStyle Libre 2+ system will face newer innovations. With the FreeStyle Libre 3 system’s features like real-time smartphone readings and ultra-thin sensors, users looking for the latest technology might consider waiting. But for those who value integrated pump technology today, the FreeStyle Libre 2+ is an excellent choice.

Cost

Like its predecessors, the FreeStyle Libre 2+ system offers significant cost advantages, being approximately 70% cheaper than other CGM brands, making it a financially accessible option for many users.

Specs

    • Includes: FreeStyle Libre 2+ reader, USB cable, power adapter, user’s manual, additional usage guides
    • Reader Operating Temperature: 50°F-113°F
    • Reader Power Source: Lithium-ion battery (rechargeable)
    • Reader Size: 95 mm x 60 mm x 16 mm
    • Reader Weight: 65 g
    • Sensor Operating Temperature: 50°F-113°F
    • Sensor Power Source: Silver oxide battery
    • Sensor Reading Range: 40-400 mg/dL
    • Sensor Size: 5 mm height, 35 mm diameter
    • Sensor Weight: 5 g
    • Compatibility: Fully compatible with t:slim X2 insulin pump for integrated care

Dexcom G7

Pros & Cons

As a frontrunner in the CGM market alongside Abbott’s FreeStyle Libre, Dexcom continues to innovate with its latest offering, the Dexcom G7. Like its predecessor, the G7 provides real-time alerts for high and low glucose levels and includes the feature to share glucose data with others, enhancing connectivity and peace of mind for users and their loved ones.

However, users should note that while the Dexcom G7 offers state-of-the-art glucose monitoring technology, it may come with a higher price tag compared to some competitors, particularly if not covered by insurance. Additionally, the sensor application process, though simplified over previous models, still requires more steps than some other systems on the market.

Cost

Investing in a Dexcom G7 is most beneficial for those with insurance coverage. It’s encouraging that Medicare and most private insurers in the US typically cover this advanced system, making it accessible to a wider audience.

Specs

  • Receiver Dimensions: Not applicable; monitored via a compatible smart device
  • Data Storage: Continuous cloud sync allows for unlimited data storage via Dexcom app
  • Operating Temperature for Device: 32°F – 113°F
  • Sensor Lifespan: Up to 10 days
  • Transmitter Dimensions: 3.81 cm (L) x 3.05 cm (W) x 0.76 cm (H)
  • Transmitter Operating Temperature: 50°F – 107.6°F
  • Transmitter and Sensor Combined Weight: 25 grams

Dexcom G6

Pros & cons

Along with Abbott’s FreeStyle Libre brand, Dexcom is among the biggest names in the CGM space. Like the FreeStyle Libre 2 system, the Dexcom G6 can notify you when your glucose level is overly high or low via notifications. Meanwhile, the Dexcom Share feature lets you share glucose information with other people.#

One caveat worth considering before picking up the Dexcom G6 is that the process of applying its sensor is a bit more complicated than the process used for FreeStyle Libre sensors.**,††,‡‡ This system might cost more than the FreeStyle Libre 14 day system or FreeStyle Libre 2 system if you buy it without insurance, too.¶,‡

Cost

If you want to buy a Dexcom G6 system, it’s wise to make sure your insurance will cover it. The good news: Medicare (and many private insurers in the US) will cover this system.

Specs 

  • Receiver Dimensions: 10.67 cm (L) x 6.35 cm (W) x 0.15 cm (H)
  • Receiver Memory Storage: 30 days of data
  • Receiver Operating Temperature: 32°F – 113°F
  • Receiver Weight: 113.4 grams
  • Sensor Lifespan: Up to 10 days
  • Transmitter Dimensions: 4.57 cm (L) x 3.05 cm (W) x 1.52 cm (H)
  • Transmitter Operating Temperature: 50°F – 107.6°F
  • Transmitter Weight: 28.35 grams (sensor included)

Are CGMs covered by insurance or Medicare?medicare coverage for cgm

Obtaining a continuous glucose monitor (CGM) typically requires a prescription, but securing insurance coverage for these devices is generally straightforward. Medicare covers CGMs under its plans, and most private insurers do the same.

Choosing US MED goes beyond standard pharmacy services. We accept both Medicare Plan B and Plan D, offering unique benefits that include personalized support, streamlined CGM processing, a convenient 90-day supply of necessary items, and direct-to-door delivery, simplifying your diabetes management.

How to see the glucose reading

The exact process of seeing glucose readouts from your CGM varies from one product to another. However, this process shouldn’t be more complicated than scanning your sensor with your reader or phone.

What do the glucose numbers mean for people with diabetes?

Type 1

Your diabetes healthcare team will help you figure out what glucose levels you should target. That said, many people with diabetes aim for these values:

  • 80-130 (before meals) 
  • Under 180 (two hours after a meal)

Type 2

The numbers listed above can also apply to people with type 2 diabetes. Again, you’ll want to ask your healthcare team about your personal target numbers.

Why choose US MED for your CGM needs?

It’s no exaggeration to say that US MED is one of America’s most accomplished diabetes supply companies. That’s partially due to the many conveniences we offer, such as automatic reorder reminders and our ability to work with Medicare and more than 500 private insurers. 

Additionally, we’ve been widely recognized as a market leader in the diabetes supply world. Over our 20-plus decades of existence, we’ve received an A+ rating from the Better Business Bureau and accreditation from the ACHC, URAC, and NABP. To start reaping the benefits of US MED’s experience and commitment to quality service, order the supplies you need online today!

 

*Taking high levels of aspirin may cause false low readings and high levels of Vitamin C may cause false high sensor readings. Refer to the FreeStyle Libre 14 day system user manual for more information.

Based on a comparison of list prices of the FreeStyle Libre 14 day system versus competitors’ CGM systems. The actual cost to patients may or may not be lower than other CGM systems, depending on the amount covered by insurance, if any.

Data on File. Abbott Diabetes Care.

  • High levels of vitamin C may affect the accuracy of sensor readings. Refer to the FreeStyle Libre 2 user manual for more information.

Based on a comparison of list prices of the FreeStyle Libre 2 system versus competitors’ CGM systems, assuming annual use of one receiver (or equivalent hardware) and quantity of transmitters and/or sensors according to use life.

#Dexcom Share is a Dexcom G6 app feature that lets users share their glucose data with up to 10 designated people, or “followers.” When your followers download the Dexcom Follow app to their compatible smart devices, they can remotely monitor your glucose data.

**FreeStyle Libre 2 User’s Manual.

††FreeStyle Libre 14 day User’s Manual.

‡‡Dexcom G6 CGM User Guide.

Read Next:

Type 1 diabetes vs Type 2 diabetes

Type 1 Diabetes vs Type 2 Diabetes

What is the Difference Between Type 1 Diabetes and Type 2 Diabetes? If you’ve recently been diagnosed with ...
cgm-prescription-for-diabetes-patients-with-medicare

Do I Need a CGM Prescription? Answers for People with Diabetes

These days, most people with diabetes have at least heard of continuous glucose monitors (CGMs). These devices allow ...
managing-mental-health-and-depression-with-diabetes

Managing Diabetes and Depression: Strategies for Your Mental Health

For people with type 1 diabetes, type 2 diabetes, or gestational diabetes, keeping up with the symptoms and ...