Ways to Find Help Affording a Continuous Glucose Monitor for Diabetes

Health Line

4 days ago

Diabetes devices using CGM technology can be costly, even for those with insurance. Consider these tips and ask your doctor, insurer, or device manufacturer about any access or affordability programs that might be available.
As much excitement as there is about continuous glucose monitoring (CGM) technology becoming the new standard of diabetes care, the reality is that it's still too expensive for many people.
Despite the proven benefits of CGM and the increasing accessibility for some with diabetes, it remains a luxury.
This disparity is even more pronounced when considering factors like race, socioeconomics, and types of diabetes, all of which significantly affect access to and use of this important tool.
What does a CGM cost?
In recent years, some research has shown that CGM tech has become more cost-effective than it once was. However, it remains out of reach for many people with diabetes.
A 2021 study confirmed that pricing is one of the biggest barriers to widespread CGM use. This trend is even more pronounced for those in lower-income households.
Without the ability to afford or access CGM tech, people lose out on a tool proven to help improve blood sugars, lower A1C levels, and generally help reduce long-term complications tied to diabetes and related health issues.
This fits into a larger pattern for people with diabetes, who face high costs and may not be able to afford the medications or supplies they need to best manage their health.
Consider that a CGM requires a prescription, so you'll have to work with a healthcare professional to get one — and those healthcare visits cost money too.
Once approved, you can buy the system and supplies for some CGMs directly from the manufacturer or a third-party medical equipment supplier like Edgepark. Some are also available in retail pharmacies like Costco, Walgreens, and Rite Aid.
Average monthly cost of CGM
When comparing out-of-pocket prices without insurance factored in, CGM system supplies can range from roughly $160 to $500 per month (based on Healthline research of manufacturer and pharmacy retail prices). Insurance and the costs for each CGM brand can vary widely.
Of course, health insurance may ease the financial burden, but it's not easy to assess just how much because health plans and approved benefits vary greatly. High deductibles and coinsurance plans require people to put down large amounts of money before their coverage kicks in.
So be sure to check with your insurance plan first to determine your coverage for obtaining a CGM system and the cost of getting the supplies you need over time.
Tips to help get CGM access
You might consider these other options to help with access or affordability for CGM technology:
1. Buy at the pharmacy
Both Abbott Libre and Dexcom CGM supplies are available in pharmacies. This may help you avoid a higher deductible through traditional medical insurance coverage.
However, some insurance plans don't allow pharmacy coverage with CGM. Convincing the plan to allow this may also require an appeal or a doctor-initiated push. Check with your insurance and doctor.
2. Seek out samples
While it's less common, some doctors' offices and clinics can have extra supplies they keep on hand that they may be willing to share with you. This won't provide a reliable or steady flow of CGM supplies, but it might be something to consider for a start.
3. Try a loaner 'professional' CGM
Rather than buying a personal CGM to use at home, some clinics offer a 'professional' CGM that you can wear for short periods to get a snapshot of your glucose data and diabetes management.
These loaner units may be 'blinded,' so that only the doctor can initially see the data to review with you afterward. People generally do not receive charges for these beyond the cost of their doctor's visits.
4. Consider a tech vacation
While this may not be ideal for everyone, some people take scattered breaks from their diabetes management every so often. This could mean not using a CGM for a brief period of time to conserve supplies and build a backup supply.
You can discuss with your healthcare team how this might work. They'll want to make sure you have a glucose meter, test strips, and lancets to use instead of the CGM sensor. An added bonus is that stepping away from diabetes devices briefly could help on the mental health front, to ease any diabetes alert fatigue you may be experiencing.
5. Ask for nonprofit aid
Some nonprofit organizations offer grants to families in need, such as Will's Way, created by an Indiana D-Mom and her son Will with type 1 diabetes (T1D). Kyler Cares out of New York also helps families afford insulin pumps and CGM supplies.
6. Find community support
People in the community do a lot to help each other out, from sharing surplus supplies to grassroots fundraising. One effort known as Mutual Aid Diabetes (MAD) frequently uses social media to amplify calls for assistance and steer people to aid programs.
Is there financial assistance for CGM devices?
Yes, the companies that make CGM technology often have programs to help people afford their devices or trial the technology before deciding to buy it.
Financial aid programs for CGM
Each of the CGM device companies offers official assistance to qualifying customers.
Abbott: This manufacturer offers financial assistance and ways for people to try the FreeStyle Libre system before buying it. Those who meet the eligibility requirements can get a voucher for a free 14-day sensor and reader with a $0 copay.
Dexcom: This company has a Dexcom Care Patient Assistance Program, which helps reduce or even eliminate out-of-pocket costs by up to 20% for the Dexcom G7 at pharmacies. Call to connect with a specialist to check eligibility: [phone].
Medtronic: Medtronic makes the MiniMed CGM and offers CGM discount access options that may lower costs for people meeting certain criteria. You can fill out an online form to check for eligibility.
Ascensia: The company that sells the Eversense implantable CGM offers a financial aid package, which includes paying as low as $199 per year for the CGM, based on eligibility.
Manufacturers' financial aid programs often change, so it's always best to check with them first to determine the available options. They may also be willing to discuss payment plans or other options to make CGM technology more accessible.
How healthcare professionals can help
'From the healthcare professional's perspective, CGM is often a cost burden and inaccessible for people who are underinsured, have lapses in health plans or new deductibles, or can't get CGM covered due to not yet meeting insurance requirements,' says diabetes care and education specialist (DCES) Julia Blanchette in Ohio.
It's more accessible now, though.
Blanchette, who also lives with T1D, says she also faces difficulties affording CGM. That helps inform how she talks with people about this technology.
'I struggled to pay for very costly CGMs for a few years. I maxed out my flex spending and found other ways to pay for the high cost, like charging my credit card until I could pay,' she said.
In Washington state, another DCES, Alison Evert, works in primary care and only sees a few people with diabetes in their 17 primary care clinics. However, she's quite familiar with CGM after years of working with the esteemed diabetes tech researcher Dr. Irl Hirsch from the University of Washington Medicine, who lives with T1D himself.
When Evert talks with her patients, she says it's important to balance expectations of what CGM tech can offer with how realistic it is for that person to use and access it.
'There's a steep learning curve, and we struggle with assisting healthcare professionals to talk with their patients about CGM,' Evert told Healthline. 'A lot of people decide they want to have it, regardless of talking about the cost and whether it's covered.
Some healthcare professionals are less familiar with CGM technology and cannot explain what a system offers to their patients. This can lead to unrealistic expectations, especially if they don't share details upfront on pricing or the nuances of obtaining insurance coverage.
It starts with setting realistic expectations. People are so excited about this technology, and we want it to be accessible to them as much as possible.