FreeStyle Libre is one of the better known brands of continuous glucose monitors (CGMs). This monitor, and others like it, have changed the game for many with diabetes.
Not too long ago if you wanted to check your blood glucose levels, you would need to need to pierce your skin several times a day. Then you’d have to feed the blood into a monitor to get a reading.
Now, thanks to this fairly new technology of continuous glucose monitors (CGMs), that’s not the case anymore. CGMs let you keep track of your blood sugar level in a less painful and invasive way. And, not only that, but CGMs are more accurate than the traditional way of checking your blood sugar level.
Abbott’s FreeStyle Libre is a popular option. And this leads many people to ask the question, “does Medicare cover FreeStyle Libre 14 Day?”
In this article, we answer that question in clear, plain English. You will also find the average costs of a FreeStyle Libre 14 Day.
Does Medicare Cover FreeStyle Libre 14 Day?
The short answer is yes; Medicare will cover the cost of a FreeStyle Libre 14 Day. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for a FreeStyle Libre 14 Day under Medicare Part B.
FreeStyle Libre 14 Day is what’s known as Durable Medical Equipment (DME) in Medicare-speak. And Medicare Part B provides coverage DMEs.
Criteria for CGM Coverage
However, you have to meet certain conditions in order to qualify for coverage. Those conditions are:
- You have to visit the doctor (in-person) who prescribes the CGM in the 6 months before you order the device
- A follow up visit with your doctor every 6 months after you get your prescription
- A diagnosis of diabetes mellitus (type 2 diabetes)
- You already use a blood glucose monitor
- Each day, you need 3+ insulin injections or you need to use a continuous insulin infusion pump
- You need to have blood sugar level tests four or more times a day
- A healthcare provider that is Medicare-approved
- A DME supplier that is Medicare-approved
- Your insulin treatment routine needs frequent adjustments
- Certification from your doctor that you meet the criteria for the CGM and that you follow the treatment plan
Medicare Part B’s coverage for FreeStyle Libre 14 Day includes:
- The patch with a thin sensor that goes under your skin to measure your blood sugar level
- The reader that collects data from the patch
These patches are good for 10-14 days and Medicare Part B will cover the cost of refillable patches.
Medicare Advantage plans (Medicare Part C) also provide coverage for a FreeStyle Libre 14 Day. They cover everything Original Medicare covers as well as some additional benefits. However, exactly what a plan covers and what the out-of-pocket costs are will vary depending on the specifics of your plan.
How Much Does FreeStyle Libre 14 Day Cost?
Most of the time a FreeStyle Libre 14 Day reader costs no more than $65. Prescriptions for FreeStyle Libre 14 day sensor prescriptions cost between $40 and $75.
If, for some reason, you need financial assistance to cover the costs of this CGM, there are other options. For example, if you need help paying your Part B copay, you may be able to get help with that through Medicaid.
Also, the manufacturer of FreeStyle Libre, Abbott, has a patient assistance foundation to help those who need financial help afford this monitor.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover intravenous iron therapy?