Medicare

Dexcom G6 is available at the distributors listed below. A patient must call their plan to confirm that the distributor is in their network.
 

No, the Dexcom G6 Medicare copayment is the same price as other popular CGM brands. Also, many Medicare beneficiaries have secondary insurance that covers their copayment.

• Has been seen in your clinic within the last 6 months
• Has type 1 or type 2 diabetes
• Uses an insulin pump or takes ≥3 daily administrations of insulin
• Requires frequent adjustments to their insulin treatment regimen based on BGM or CGM testing results

For a complete description of Medicare coverage criteria and additional information related to what should be included in the chart notes, please visit the Centers for Medicare and Medicaid services website.

Yes. The Dexcom G6 is now available for patients who meet the Medicare coverage criteria.

For a complete description of Medicare coverage criteria visit the Centers for Medicare and Medicaid services website.

HCPs can prescribe Dexcom G6 to one of the distributors below via the following steps:

• Send the patient’s certificate of medical necessity (CMN) and chart notes to the distributor
• Let your patient know that they will be contacted by the distributors below regarding their Dexcom G6 order

A patient must call their plan to confirm that the distributor is in their network.

Dexcom has decided to refer all Medicare patients to trusted distributors with experience serving Medicare patients. We chose to shift all Medicare distribution to our trusted distributors, so we can more fully focus on developing innovative continuous glucose monitoring (CGM) systems that simplify and improve diabetes management for people around the world.

If a Medicare patient is denied coverage for Dexcom G6, it will be the distributor’s role to advise the patient or provider on the next steps for obtaining coverage.

If a current Dexcom G6 patient “ages into” Medicare eligibility (i.e., turns 65), they will be treated as a new patient. Prescribers should follow the new patient prescription process.

Medicare patients currently using Dexcom G5 will be automatically updated to Dexcom G6 when their G5 transmitter is out of warranty. This means they will automatically get a new Dexcom G6 transmitter and sensors with instructions on how to update the receiver and app. If they do not have a compatible receiver, they will get a new Dexcom G6 receiver. The existing Detailed Written Order (DWO) will be honored.

Dexcom Tech support - 1-844-607-8398
Dexcom CARE team - 1-877-339-2664
Medicare G6 HCP site - provider.dexcom.com/prescribe/medicare
Medicare G6 Patient site - www.dexcom.com/medicare

Full list of Medicare coverage criteria see the applicable coverage policy.