Medicare Part B covers continuous glucose monitors (CGMs) as durable medical equipment when specific criteria are met. As of the most recent CMS guidelines, you generally qualify if: (1) you have a diagnosis of diabetes (Type 1 or Type 2); (2) you are treated with insulin OR have a documented history of problematic hypoglycemia (regardless of insulin use); (3) you have had an in-person or approved telehealth visit with your treating practitioner within the past 6 months to evaluate your diabetes management; and (4) your prescriber documents that the CGM is medically necessary. Medicare typically covers the CGM device, sensors, and transmitter, with the standard 20% coinsurance after the Part B deductible (supplemental insurance may cover the remainder). Always confirm current eligibility, as CMS guidelines are periodically updated.
Medicare Part B covers CGMs for diabetic patients on insulin or with problematic hypoglycemia, when prescribed after a recent in-person evaluation and documented as medically necessary.