Who does insurance cover for CGM?
CGM coverage has expanded significantly over the past several years. As of 2026, most major insurance plans and Medicare cover CGM for the following groups:
Type 1 diabetes: virtually universally covered. CGM is considered standard of care for Type 1 diabetes management, and coverage is broadly available across Medicare, Medicaid, and private insurers.
Type 2 diabetes on insulin: covered by most plans including Medicare. If you use any form of insulin — basal, bolus, or mixed — CGM is typically covered.
Type 2 diabetes on non-insulin medications: coverage is expanding but inconsistent. Some plans cover CGM for non-insulin Type 2 patients; others require prior authorization with documentation of clinical need. This varies significantly by insurer and plan.
Prediabetes and prevention: generally not covered. OTC CGMs are available without a prescription for this population, but insurance reimbursement is rare.
Medicare CGM coverage in 2026
Medicare covers CGM under the Durable Medical Equipment (DME) benefit for beneficiaries who:
Have diabetes and use insulin — this includes Type 1 and Type 2 patients on any insulin regimen. As of 2023, Medicare expanded coverage to remove the requirement for "intensive" insulin therapy, meaning any insulin use now qualifies.
Have a treating physician who documents medical necessity — your prescriber needs to certify that CGM is clinically appropriate for your situation.
Under Medicare, CGM devices and sensors are covered at 80% after the deductible, with the remaining 20% typically covered by supplemental insurance (Medigap). Most covered patients pay little to nothing out of pocket.
Covered devices under Medicare include the Dexcom G7, FreeStyle Libre 3, and Medtronic Guardian 4. OTC devices (Stelo, Lingo) are not covered by Medicare.
How to get CGM covered by insurance
Step 1 — Get a prescription. Your prescriber (endocrinologist, primary care, or diabetes care provider) needs to write a CGM prescription. Mention specifically which device you want — not all devices are covered equally by all plans.
Step 2 — Check your formulary. Contact your insurance and confirm which CGM brands and models are on your plan's formulary. Dexcom and Abbott are typically covered; some plans have preferred brands with lower cost sharing.
Step 3 — Prior authorization if required. Many plans require prior authorization before approving CGM. Your prescriber's office typically handles this — they submit documentation of your diagnosis, insulin use, and clinical need. This process can take 1–2 weeks.
Step 4 — Appeal if denied. If coverage is denied, you have the right to appeal. Denials are often overturned on first appeal, particularly when your prescriber submits additional clinical documentation. Ask your prescriber's office for help with the appeals process.
OTC CGM options if you're not covered
If you don't qualify for insurance coverage — or you want a CGM without navigating the prescription process — OTC devices are available without a prescription at $89–99/month:
Dexcom Stelo — $89–99/month, 15-day wear, no prescription. Available at CVS, Walgreens, Amazon. Check price on Amazon →
Abbott Lingo — $89/month, 14-day wear, no prescription. Available direct from Abbott.
HSA/FSA: OTC CGMs may be eligible for reimbursement through HSA (Health Savings Account) or FSA (Flexible Spending Account). Check with your plan administrator.