The short answer Many plans, including Medicare, now cover continuous glucose monitors for people who use insulin, and increasingly for people with a documented history of problem low blood sugar even without insulin. The deciding factor is usually documentation from your prescriber, not the diagnosis alone. What plans generally look for A diagnosis of diabetes documented in the chart. Insulin use, or a history of problematic hypoglycemia. Criteria have loosened over time; basal-only insulin now qualifies under many plans. A recent in-person or telehealth visit with the prescribing clinician — often within the last six months. A treatment plan showing the CGM data will be used to manage therapy, with ongoing follow-up. A signed order specifying the device and supplies. What sinks most requests is not eligibility — it is chart notes that do not explicitly state the pieces above. Pharmacy benefit or medical benefit? CGMs can be billed either way depending on your plan. Under a pharmacy benefit you typically pick up sensors at a pharmacy with a copay. Under a medical benefit (common with Medicare), sensors ship from a supplier like us and are billed as durable medical equipment with coinsurance after your deductible. Neither route is universally cheaper. We check both when we run your benefits so you can see the real monthly number. What it typically costs With coverage, most people pay a monthly copay or coinsurance on sensors, with the reader replaced infrequently (many patients use a phone app instead of a separate reader). Without coverage, cash prices vary significantly by brand, which is one reason FreeStyle Libre often comes up in cost conversations. Deductibles reset each January, so a January or February bill may look very different from December. That surprise is normal, not an error. If you are denied A denial is frequently a documentation gap, not a final answer. The usual fix is a supplemental note from your prescriber that spells out insulin use or hypoglycemia history, the visit date, and how CGM data will change management. Appeals succeed regularly when that language is added. We will tell you exactly which element was missing and coordinate with your prescriber office to get it corrected. How we handle it Our workflow is largely automated: we verify benefits, request the documentation your plan requires, and track the authorization through to shipment. Prescribers can send orders through Parachute Health, which cuts most of the fax-and-callback cycle out of the process. You get a status update rather than silence. Your next step today Gather your insurance card and the name of your prescribing clinician, then start an enrollment. We will run the benefits check and tell you what your plan requires before you commit to anything. 1000