Medicare Expansion Will Make Dexcom More Accessible
The Centers for Medicare and Medicaid Services (CMS), the government agency that administers Medicare for over 65 million Americans, announced an expansion of their coverage for continuous glucose monitor (CGM) systems on Monday, April 17, 2023.
What Medicare’s coverage expansion will cover
This coverage expansion will include people with diabetes who are on any type of insulin, including just a single daily dose of basal insulin, and some non-insulin-dependent individuals with a history of severe low blood sugar levels.
Medicare previously covered CGMs for people with diabetes who received intensive insulin therapy of three or more daily injections. This expansion is a huge advocacy win for the diabetes community and is the most significant single expansion of CGM coverage in United States history.
This change will allow coverage of any CGM brand, including Dexcom.
The MOBILE study
The Dexcom-backed MOBILE study was the primary scientific evidence that led to the CMS’s decision. The study showed that using a CGM significantly improves HbA1c levels and increases time in range (TIR), even for adults with type 2 diabetes who only use basal insulin.
Dexcom applauds this decision, stating that the MOBILE study is part of their ongoing effort to expand access to CGMs to help people improve their diabetes management and overall quality of life.
Dr. Thomas Martens, key study investigator and internal medicine physician, said, “This is a major win for the diabetes community and another validation of how CGMs can benefit all people living with diabetes.”
CGMs have proved to bear extensive benefits for people with type 1 and type 2 diabetes who use intensive insulin therapy, but this groundbreaking study reveals that CGMs are beneficial for people on any kind of insulin therapy—not just for those who bolus for meals.
Medicare enrollees on basal insulin will also have access to Dexcom’s newest release, the G7—currently the most accurate CGM on the market. This Medicare coverage expansion will give 1.5 million more people in the U.S. access to life-saving technology.
Hopes that private insurance will follow
While this is a great win for the diabetes community, private health insurance coverage of CGMs is still unstable. People with diabetes must often navigate a complicated web of health insurance obstacles and barriers to accessing these devices. Not all insurance plans cover CGMs for people with diabetes.
Sometimes, initiatives like this can spur change in the private sector. That future is yet to be seen, but the diabetes community is hopeful and continues to advocate. Often, private health insurance plans look to Medicaid and Medicare when determining their coverage policies—an expansion as significant as this is bound to make waves.