Heading to your healthcare provider’s office for a check-up during the pandemic poses a real threat if you manage a condition, such as diabetes, that could determine how severely ill you become if you contract Covid-19.
Because of this and the prediction that the pandemic will continue further into 2022, the Centers for Medicare & Medicaid Services (CMS) have temporarily suspended the current LCD clinical indications for continuous glucose monitors (CGMs) during Covid, which is considered a Public Health Emergency (PHE).
So, what does that mean for people with diabetes?
As long as the nation is in a state of PHE, you may qualify for a CGM through Medicare with Aeroflow Diabetes if you inject insulin just 1x a day, rather than the standard 3x injections per day!
Read this post to learn more about the new insulin injection requirement and see if you qualify to get your CGM covered by Medicare with Aeroflow Diabetes.
How Does the Suspension Change CGM Coverage?
Under the temporary suspension of the LCD clinical indications for CGM systems, it is no longer required for people with type 1 diabetes or type 2 diabetes to inject insulin 3 times a day to qualify for Medicare coverage for a CGM.
Because of this change, Aeroflow Diabetes has temporarily altered its CGM coverage requirements from 3x insulin injections a day to x1 injection per day. This suspension also allows healthcare providers more opportunities to prescribe CGMs to people with diabetes who manage their blood sugar levels.
Injecting insulin at least 3x/day = Injecting insulin at least 1x/day.
Those who qualify under these temporary criteria may be eligible for coverage of the blood glucose monitoring devices Aeroflow Diabetes carries. These include:
Abbott CGMs:
- FreeStyle Libre 2 System.
- FreeStyle Libre 3 System (estimated to become available this year).
Dexcom CGMs:
- Dexcom G6.
- Dexcom G7 (estimated to become available this year).
Who Qualifies?
You may now qualify for CGM coverage with Aeroflow Diabetes if you:
- Are diagnosed with diabetes.
- Have a signed order for a CGM.
- Have progress notes from your healthcare provider showing that the coverage criteria are met.
- Have a documented need for a CGM in your medical records.
- Have a medical need for a CGM device justified by your healthcare provider.
- Are enrolled in a Medicare Primary / Traditional Medicare Plan.*
*It’s important to note that those enrolled in a Medicare Advantage Plan are not eligible to receive CGM coverage under these new guidelines. Those with Medicare Advantage Plans are still required to inject insulin 3x per day to qualify for CGM coverage through Aeroflow Diabetes.
What Happens to Coverage After the Pandemic?
Currently, the CMS has not announced any updated guidelines on handling clinical LCD requirements when the PHE is no longer in effect.
Aeroflow Diabetes will post timely updates on our insulin injection requirements if the CMS’ current suspension of the 3x injection per day requirement is implemented.
How to Get a CGM Through Medicare and Aeroflow Diabetes
Diabetes management has been made much easier with CGMs; Painful fingersticks are no longer needed to check your blood glucose levels, and newer models of these devices are further improving the way CGMs work. Getting real-time glucose readings is faster than ever before, CGM sensors are shrinking in size, and glucose data can now be read on smart devices and even Apple Watches anywhere you go with your CGM.
If you have diabetes and require a blood glucose meter to help control low blood sugar or high blood sugar, one of the best ways to obtain one is to get it through insurance coverage with the help of Aeroflow Diabetes.
If you are not yet using Aeroflow Diabetes to get your CGM through your Medicare health insurance plan, now is the best time to do so; Our current 1x insulin injection per day requirement may be only temporary, so see if you qualify with our 2-step Eligibility Form!
If you do qualify, we’ll send your glucose monitoring system directly to your door for free.
About the Author
Marlee Septak is the Senior Content Specialist at Aeroflow Urology. She brings a deep understanding of incontinence and health conditions associated with it to her writing. She graduated from Columbia College Chicago and holds a Bachelor's degree in Journalism. Marlee has contributed to various magazines and blogs, including Borgen Magazine, Echo Magazine, Chicago Ideas Week, Assuaged, and Peaceful Dumpling. In her spare time, she enjoys traveling, trying new restaurants, and just sitting down with a good book.
https://www.cgsmedicare.com/jc/pubs/news/2020/06/cope17942.html
Information provided on the Aeroflow Diabetes website is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to diabetes care.
The 1x insulin injection per day is subject to change and we will update this post with changes as they arise.
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