Medicare

Where can patients fill their Dexcom G6 scripts?

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

 

Distributor

Phone Number

Byram Healthcare

800-775-4372

CCS Medical

800-949-6481

US Med

866-934-5715

Solara Medical Supplies

800-423-0896 opt 2

Edgepark

866-400-5183 opt 2

USHL

866-421-2732

Edwards Healthcare

888-344-3434

Advanced Diabetes Supply

877-838-3026

Diabetes Management Supply

888-738-7929

BLN

800-854-5729

Mini Pharmacy

888-545-6464

Is the Dexcom G6 Medicare copayment more expensive than for that of other CGM brands?

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.

What patient information is required within chart notes to ensure eligibility along with CMS Medicare coverage criteria?
  • 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.

Does Medicare cover Dexcom G6?

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

What is the Medicare coverage criteria?

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

How can HCPs prescribe Dexcom G6 to their Medicare patients?

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

 

Distributor

Phone Number

Byram Healthcare

800-775-4372

CCS Medical

800-949-6481

US Med

866-934-5715

Solara Medical Supplies

800-423-0896 opt 2

Edgepark

866-400-5183 opt 2

USHL

866-421-2732

Edwards Healthcare

888-344-3434

Advanced Diabetes Supply

877-838-3026

Diabetes Management Supply

888-738-7929

BLN

800-854-5729

Mini Pharmacy

888-545-6464

 

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

Why is Dexcom referring patients to distributors?

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.

What if the patient’s claim is denied at the distributor?

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.

For patients currently using Dexcom G6 who turn 65 (becoming Medicare-eligible), how will they be transitioned to Dexcom G6 for Medicare?

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.

When will existing Medicare patients have access to Dexcom G6?

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.

Where can I get more information or support for my office or my patients?

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

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

Contact Us

If you are a healthcare provider and want to learn more about Dexcom, please fill out the form and a representative will contact you. If you are a Dexcom User or Patient, please contact Dexcom here.

Contact Reason

 

By choosing to request info, you are granting Dexcom, Inc. permission to process your personal information to send you additional information and promotional communications related to Dexcom products. You may opt-out of these communications at any time. Dexcom respects the privacy and confidentiality of your personal information. The information you provide will be sent securely and subject to the Dexcom Terms of Use and Privacy Policy.