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How to Qualify for a Free CGM Through Medicare: Complete Guide

Medicare Specialist Reviewed
Updated January 2025

Good News!

Most seniors with diabetes qualify for Medicare-covered CGM devices. Over 90% of our callers who meet basic requirements get approved for free CGM coverage.

Basic Medicare Requirements

To qualify for Medicare-covered CGM, you must meet these essential criteria:

Required Qualifications

  • Medicare Part B enrollment - Must be active and current
  • Diabetes diagnosis - Type 1 or Type 2 diabetes
  • Insulin therapy - Currently taking insulin OR frequent blood sugar testing
  • Doctor's prescription - Healthcare provider must prescribe CGM
  • Frequent testing - Currently test blood sugar 4+ times daily

Detailed Qualification Criteria

Medicare Part B Coverage

CGM devices are covered under Medicare Part B as durable medical equipment (DME). You must have:

  • Active Medicare Part B enrollment
  • Met your annual Part B deductible
  • No outstanding Medicare issues or suspensions

Medical Requirements

Your medical history must demonstrate the need for continuous glucose monitoring:

  • Documented diabetes diagnosis (Type 1 or Type 2)
  • Current insulin therapy OR multiple daily blood sugar checks
  • History of blood sugar fluctuations
  • Ability to use the CGM device safely

Special Circumstances

You may also qualify if you have:

  • • Hypoglycemia unawareness (can't feel low blood sugar)
  • • Frequent severe low blood sugar episodes
  • • Dawn phenomenon (morning blood sugar spikes)
  • • Difficulty managing diabetes with traditional testing
  • • Physical limitations that make fingerstick testing difficult

The Qualification Process

Step 1: Initial Assessment

When you call our Medicare specialists, they'll review:

  • Your Medicare coverage details
  • Current diabetes management routine
  • Medical history and medications
  • Previous blood sugar testing frequency

Step 2: Doctor Coordination

We work with your healthcare provider to:

  • Obtain necessary medical documentation
  • Secure CGM prescription
  • Complete Medicare prior authorization if needed
  • Schedule follow-up appointments

Step 3: Medicare Approval

Our team handles all Medicare paperwork:

  • Submit coverage determination request
  • Provide required medical documentation
  • Follow up on approval status
  • Handle any appeals if necessary

Check Your Qualification Status

Call now for a free qualification assessment. Our Medicare specialists will determine if you qualify and handle all the paperwork for you.

Call Now: 1-833-448-3412

Free assessment • No obligation • Same-day qualification review

What If I Don't Qualify?

If you don't meet the standard Medicare requirements, there may still be options:

  • Medicare Advantage plans - May have different coverage rules
  • Supplemental insurance - Could provide additional coverage
  • Manufacturer programs - Patient assistance programs available
  • Alternative testing methods - Other covered diabetes supplies

Timeline for Approval

Typical Timeline:

  • Day 1: Initial qualification call and assessment
  • Days 2-5: Doctor coordination and prescription
  • Days 6-14: Medicare review and approval
  • Days 15-21: Device shipment and setup

*Timeline may vary based on individual circumstances and Medicare processing times

Your Next Step

The qualification process is completely free and there's no obligation. Our Medicare specialists will review your specific situation and let you know exactly what options are available to you. Most seniors are surprised to learn they qualify for full coverage.

Find Out If You Qualify Today

Don't wait to see if you qualify for Medicare-covered CGM. Call now for your free assessment.

1-833-448-3412