he FreeStyle Libre, Insurance Coverage and More
Over the years, Continuous Glucose Monitors have increased in popularity and become more readily available in the quest to control and manage diabetes.
As a result, several companies have created their own version of the Continuous Glucose Monitor.
More options mean more choices and deciding which Continuous Glucose Monitor to choose can be a very difficult decision.
Even after researching and comparing the various features, factors like cost and insurance coverage can be the obstacle that prevents patients from making the right decision.
At Quest Health Solutions, our patient’s best interest is our number one priority and that is why we take great pride in providing the information needed to make an informed decision.
We are one of the leading suppliers of Continuous Glucose Monitors, and we are proud to say that we have definitely done our research.
We’d like to share that with you and hope to briefly introduce the different CGM brands, highlight their features and give you our top pick and the reasons why.
Continuous Glucose Monitor Brands
There are currently four FDA-approved CGM systems on the market today. They are the Dexcom, Medtronic, Freestyle Libre, and Senseonics. All four systems use a sensor that is inserted subcutaneously as well as a transmitter and receiver to allow for data collection. Each provide reporting that records and tracks activity to show trends and aid in overall management. Let’s take a closer look at each one.
Dexcom
The Dexcom is considered the pioneer in CGM systems. It uses its own software called Clarity and offers customizable alerts, smartphone app compatibility and voice integration through Apple’s Siri technology. Data can be shared with up to 10 followers and can be used in patients as young as two.
- ❖ Price1: $300 for the transmitter. $600 for the receiver. $80 per sensor.
- ❖ Sensor life is 10 days.
- ❖ Covered by most private and public health insurance plans and Medicare.
Medtronic
Medtronic is considered the leader in insulin pump technology, but also makes a CGM device called the Guardian Connect. Dexcom’s sensor can be worn on the abdomen or upper arm for up to seven days. A Bluetooth transmitter can send glucose readings to a smart phone app every five minutes. The Guardian Connect is also FDA approved and can be used in patients aged 17-75.
- ❖ Price1: $1000 for the transmitter. $80 for the sensor.
- ❖ Sensor life is 7 days.
- ❖ Covered by most private plans, but not Medicare
FreeStyle Libre
The FreeStyle Libre uses a flash sensor that allows the patient to be in control of their own readings. Using a handheld receiver or smart phone app, patients can hover over the sensor to get readings which can even occur through clothing. The sensor is also waterproof and can be worn while swimming or bathing. It’s also small and lightweight and can be worn for up to 14 days. The FreeStyle Libre also has its own software and smart phone app and offers remote data sharing with up to 20 people.
- ❖ Price1: $60 for the sensor scanner. $40 per sensor.
- ❖ Sensor life is 14 days.
- ❖ Covered by most private and public health insurance plans and Medicare.
Senseonics Eversense System
The Eversense system is the world’s first implantable CGMs. Its sensor is the size of a small twig, implanted in the upper arm, and is approved for 90 days of wear here in the United States and even longer in certain European countries. Like the other CGMs, it also has a downloadable smart phone app for easier tracking and reporting. The Eversense system was on a brief hiatus and has recently re-entered the US market.
- ❖ Price: $1400 for initial package which includes sensor, transmitter, adhesives, start guide). Then $200 to $300 for insertion and $300 to $400 for removal and reinsertion.
- ❖ Sensor life is 90 days.
- ❖ Covered by most private plans, but not Medicare
Which Insurance Companies Cover Continuous Glucose Monitors?
Today, most major health insurance plans do provide some level of coverage for CGMs when prescribed by a qualifying physician. Some of the major insurance companies that cover Continuous Glucose Monitors include Cigna, United Healthcare, Blue Cross and Blue Shield, Aetna, Humana, and Kaiser.
CGMs are covered because they are considered durable medical equipment which is any type of medical device that serves a health care purpose. In order to qualify as a DME, the device must be prescribed for medical reasons and must be medically necessary in order to complete daily activities. DME’s must also be durable and withstand repeated use.
Medicare Coverage of Continuous Glucose Monitors
Medicare is often overlooked as a viable option to cover the costs of Continuous Glucose Monitoring Systems (CGMs). That is due in part to the fact that until recently Continuous Glucose Monitors were not covered by Medicare.
Thanks to recent changes, Medicare now covers many CGM brands under the durable medical equipment category. In 2017, Medicare made a change that began to open doors for CGMs and diabetes patients everywhere. The first major hurdle allowed certain CGMs to be covered by Medicare if they were deemed therapeutic.
By 2020, all but one CGM device on the market was covered. “As of October 2020, all CGM devices on the market with the exception of those from Medtronic Diabetes are covered by Medicare. These include the Dexcom G6, the Abbot FreeStyle Libre 1 and 2, and the implantable Eversense CGM from Senseonics.”
Why the FreeStyle Libre is our First Choice in Continuous Glucose Monitoring
The three most popular monitoring systems on the market today are the Dexcom, Medtronic, and the Freestyle Libre. There are many similarities among all three. Here’s a quick review of the factors that set them apart and why the FreeStyle Libre gets our vote:
- ❖ Insertion/Ease of Use – The Freestyle Libre has the easiest process and requires only a single-step insertion. The Dexcom has a two-step process that involves a complicated taping procedure. Medtronic devices require a multi-step process that also involves taping of both the sensor and transmitter.
- ❖ Wear Time – The Freestyle Libre is the longest lasting self-applied sensor on the market today and can be worn for 14 days. Dexcom’s sensor wear time is 7 days and Medtronic’s is 6 days.
- ❖ Calibration – The Freestyle Libre does not require calibration. Dexcom requires calibration twice daily and Medtronic requires calibration 3 to 4 times daily.
- ❖ Care Between Use – The Freestyle Libre is easy to use and maintain. It has a disposable sensor and transmitter. The transmitter in the Dexcom and Medtronic must be cleaned and disinfected after each use. The Dexcom also requires that the receiver be cleaned and disinfected as well.
- ❖ Insertion site – The Freestyle Libre is placed on the back of the upper arm. The sensor is the size of two stacked quarters and easily accessible through clothing. Both Dexcom and Medtronic sensors are placed on the abdomen.
- ❖ Cost – Of the 3 devices, the Freestyle is the most affordable especially for patients responsible for coinsurance.
The Freestyle Libre is our choice because it’s convenient, easy to use and provides patients more freedom and control. Each Freestyle Libre scan provides a current glucose reading, a trend arrow and an 8-hour history. The Freestyle Libre gives patients and healthcare providers an easy way to track daily patterns, ranges and targets and can receive alerts when they are trending high or low. Using the Freestyle Libre in conjunction with the LibreView downloadable app allows patients to retrieve readings right from their smart device. Data can be shared with healthcare providers and up to ten followers which helps patients with the overall management of Diabetes and helps to keep glucose levels under control. The FreeStyle Libre is also the least expensive and covered by most major health insurance companies. It is also covered by Medicare for patients that meet the qualifications.
Where to Find the FreeStyle Libre
While the Freestyle Libre is becoming more readily available through various channels, the qualifying process can be daunting for both patients and providers. At Quest Health Solutions, we can guide you through the entire process. Our experienced team can handle all of the paperwork, insurance verification, billing and authorization calls. To learn more about the Freestyle Libre and our CGM Fulfillment Solutions, contact Quest Health Solutions at 1-877-888-7050 Ext. 1011, email ben@questhealthsolutions.com or schedule an appointment today.
1. (2020) Endocrinology Advisor. Available at Click Here accessed on 4 October 2021.
2. (2021) Healthline. Medicare Loosening Restrictions for Continuous Glucose Monitor Coverage. Available at Click Here accessed on 4 October 2021.