Does Medicare Cover CGMs for Type 2 Diabetes?

Yes — type 2 diabetes is covered

Medicare's CGM coverage rules apply to a diabetes diagnosis of any type — type 1, type 2, or gestational. Type 2 is not excluded. Having type 2 diabetes by itself is not enough, though; you also have to meet one of the two eligibility pathways below.

CGMs are covered under Part B as durable medical equipment (DME), the same category as wheelchairs and oxygen equipment. They are not covered through Part D pharmacy benefits. That means you must be enrolled in Part B (and pay its monthly premium) to get a Medicare-covered CGM.

How to qualify: the two pathways

To get a Medicare-covered CGM, you need a diabetes diagnosis plus EITHER of the following two pathways.

• Insulin pathway: You are treated with insulin in any regimen. This includes long-acting (basal) insulin alone — you do not have to inject multiple times a day.
• Problematic-hypoglycemia pathway: You have a documented history of problematic low blood sugar. This is how a type 2 patient who does NOT use insulin can qualify.

What counts as 'problematic hypoglycemia'

Medicare defines problematic hypoglycemia as documentation in your medical record of at least one of the following situations.

Your doctor must document this in your records. If you have low blood sugar episodes, talk with your treating practitioner about whether your history meets this definition.

• Recurrent (more than one) level 2 hypoglycemic events — blood glucose below 54 mg/dL — that keep happening despite multiple attempts to adjust your medication and/or change your treatment plan; OR
• A history of one level 3 hypoglycemic event — blood glucose below 54 mg/dL with an altered mental or physical state that required help from another person.

What changed in April 2023

Effective April 2023, CMS expanded who can get a Medicare-covered CGM. The update made coverage broader, which is why many type 2 patients who were previously denied may now qualify.

• It removed the old requirement to use insulin three or more times a day, so any insulin use — including basal-only insulin — now qualifies.
• It removed the minimum fingerstick-testing requirement.
• It added the problematic-hypoglycemia pathway, making non-insulin patients eligible for the first time.

Doctor visits, training, and documentation

Medicare requires several things to be in place and recorded in your medical record before and during coverage.

• A visit before ordering: Within the 6 months before the CGM is ordered, your treating practitioner must see you in person (or by Medicare-approved telehealth) to evaluate your diabetes control and confirm you meet the criteria.
• Ongoing visits: To keep coverage, you must have an in-person or telehealth visit at least every 6 months.
• Training: You (or a caregiver) must be adequately trained to use the CGM system.
• FDA-indicated use: The CGM must be prescribed in line with the FDA's approved indications for the device.
• Documentation: Medical necessity and training must be documented in your record.

Covered devices and the receiver rule

Medicare-covered CGM systems include the Abbott FreeStyle Libre 2 Plus and Libre 3 Plus (older Libre versions were phased out as of September 2025), the Dexcom G6 and G7, and the Eversense implantable CGM. Always confirm a specific model with your supplier before you order.

There is one technical catch worth knowing. For DME coverage, the CGM system must use a stand-alone receiver that qualifies as DME (or integrate with an insulin infusion pump). A device that only displays results on a smartphone, with no stand-alone receiver, does not meet the DME definition and is denied as non-covered. You can still use a compatible phone or watch to view your readings — but only if you also use the dedicated receiver at least some of the time.

What a CGM costs with Medicare

Because CGMs fall under Part B DME, normal Part B cost-sharing applies. A Medicare Supplement (Medigap) policy may cover some or all of the 20% coinsurance, depending on the plan you have.

• Part B deductible (2026): $283 per year — you pay this first.
• Coinsurance: After the deductible, you pay 20% of the Medicare-approved amount, and Medicare pays 80%, as long as your supplier accepts assignment.
• Part B premium (2026): The standard premium is $202.90 per month. You must be enrolled in Part B to get a Medicare-covered CGM.

Where to get it and Medicare Advantage

Get your CGM from a DME supplier enrolled in Medicare — not the pharmacy counter, since CGMs are billed as DME, not as a Part D drug. Your doctor's office can usually help you find an enrolled supplier and send the prescription with the required documentation.

If you have a Medicare Advantage (Part C) plan, the plan must cover at least the same CGM benefits as Original Medicare Part B. However, your cost-sharing, the supplier network you must use, and prior-authorization rules can differ by plan. Check your plan's Evidence of Coverage or call the number on your member ID card to confirm the details before you order.