Managing diabetes is a daily commitment, and having the right tools is essential. For millions peoples on Medicare, a key question is: "How do I get a glucose monitor covered?" The process can seem confusing, but it's more straightforward than you might think. This guide for 2025 will provide a clear, step-by-step path to getting a traditional blood glucose monitor (BGM) or a modern Continuous Glucose Monitor (CGM) through your Medicare benefits.
1. Understand Your Options: BGM vs. CGM
First, it’s important to know that Medicare covers two main types of glucose monitors, and the one you qualify for depends on your medical needs.
- Blood Glucose Monitors (BGMs): This is the traditional method involving a fingerstick to place a drop of blood on a test strip. Medicare Part B covers these meters, along with test strips, lancets, and control solutions, for people with diabetes.
- Continuous Glucose Monitors (CGMs): These are modern, wearable devices that automatically track your glucose levels 24/7 via a small sensor, no routine fingersticks required. As of 2025, Medicare coverage for CGMs like the FreeStyle Libre and Dexcom systems has expanded significantly. It now covers many individuals who use any type of insulin or who have a history of problematic hypoglycemia.
Discuss with your doctor which type is medically appropriate for you, as CGMs offer far more data and can help prevent dangerous low blood sugar events.
2. Step 1: The Doctor's Visit and a Valid Prescription
You cannot simply buy a monitor and have Medicare pay for it. A glucose monitor is considered "Durable Medical Equipment" (DME), and the first and most critical step is getting a prescription from your doctor who accepts Medicare.
During your visit, your doctor must document your diagnosis of diabetes. If you are seeking a CGM, they must also specifically document your insulin use or history of hypoglycemia. Your doctor will write a prescription that specifies the type of monitor, how often you need to test, and the necessary supplies. This prescription is the key that unlocks your benefits.
3. Step 2: Finding a Medicare-Approved Supplier
This is a crucial step that many people miss. You must get your glucose monitor and supplies from a pharmacy or medical equipment company that is enrolled in Medicare and "accepts assignment."
"Accepting assignment" means the supplier agrees to accept the Medicare-approved amount as full payment. They will bill Medicare directly, so you don't have to pay the full cost upfront and wait for reimbursement. You can find an approved supplier by:
- Using the official "Medicare.gov/suppliers" search tool.
- Asking your doctor's office for a recommendation of a local or mail-order supplier they work with.
- Contacting a national diabetic supply company that is Medicare-approved.
Using a non-approved supplier will likely result in you having to pay 100% of the cost out-of-pocket.
4. Understanding Your Costs: Deductibles and Coinsurance
"Covered by Medicare" does not always mean "free." Under Medicare Part B, you are typically responsible for some costs:
- The Part B Deductible: You must pay this amount out-of-pocket each year before Medicare begins to pay its share.
- 20% Coinsurance: After your deductible is met, Medicare pays 80% of the approved amount for the monitor and supplies. You are responsible for the remaining 20%.
Many Medicare Supplement (Medigap) plans cover the 20% coinsurance, so if you have one of these plans, your out-of-pocket costs could be $0. Check with your Medigap plan provider to confirm your benefits.