FreeStyle Libre Medicare CoverageNovember 19, 2019
FreeStyle Libre is a continuous glucose monitor (CGM) that consists of a small, water-proof, fully disposable sensor that you wear on your arm for 14 days, plus a reader device.
The reader shows your blood glucose levels in real time, and it doesn’t require a finger stick like most CGMs do. FreeStyle Libre is approved for monitoring blood glucose levels in both Type 1 and Type 2 diabetics.
FreeStyle Libre Medicare coverage is much like other Medicare coverage for durable medical equipment (DME). You may have to pay coinsurance or copays, and you have to purchase your DME from a Medicare-approved supplier.
How does FreeStyle Libre Medicare Part B coverage work?
Medicare Part B is medical insurance, and it helps pay for outpatient doctor’s appointments, preventive care such as diabetes screenings, and durable medical equipment (DME). In order for Medicare to approve your DME, your doctor must prescribe it, and it must be a device that will last for three years or more.
You may be responsible for 20 percent of approved Medicare costs for FreeStyle Libre including the equipment itself and your doctor’s supervision.
Medicare Supplement Coverage for FreeStyle Libre
Medicare Supplements (Medigap) plans are private insurance plans that can help pay for expenses that you may incur with Original Medicare (Part A and Part B) such as coinsurance and copays. They work like this: you pay a monthly premium, and your copays and coinsurance, including what you’d pay for durable medical equipment, are covered.
Medicare Advantage FreeStyle Libre Coverage
Medicare Advantage (MA or Part C) plans are also private plans. They work differently than Medigap plans because MA plans offer additional benefits rather than help paying for financial items.
You cannot have both a Medigap plan and a Part C plan, so it’s best to contact your agent to discuss your individual needs, including coverage for diabetes and durable medical equipment.
How much does FreeStyle Libre cost without insurance?
According to GoodRx, FreeStyle Libre can cost about $135 every two weeks. That adds up to $3,510 per year.
Medicare Coverage for Insulin
Original Medicare does not help cover insulin unless it’s in conjunction with an insulin pump. Medicare Part D or certain Medicare Advantage plans may help cover insulin products such as Lantus and Novolin.
According to GoodRx, Lantus is the most popular insulin drug. The average copay is $37.50-$67.50.
Where can I get FreeStyle Libre?
You can get FreeStyle Libre at most major pharmacies, however, Medicare may only cover the device if you get it at a “participating DME supplier.” According to Abbot, the FreeStyle Libre manufacturer, Medicare will help pay for the device if you purchase it from one of the following suppliers:
- Advanced Diabetes Supply
- Better Living Now
- Byram Healthcare
- CCS Medical
- Diabetes Management & Supplies
- Edgepark Medical Supplies
- Edwards Health Care Services
- HealthLink Solara Medical Supplies
- J&B Medical Supply
- Mini Pharmacy
- United States Medical Supply
In order for Medicare to cover your durable medical equipment, your doctor must say it’s medically necessary. You may need to have periodic follow-up appointments in order for Medicare to continue covering FreeStyle Libre.
How do I use a FreeSyle Libre system?
With the FreeStyle Libre 14-day system, you’ll wear a small sensor on the back of your upper arm that automatically* monitors your glucose 24 hours a day.
Instead of finger pricks**, you simply swipe the reader over the sensor on your arm for a painless, one-second scan. Each scan provides an up-to-the-minute glucose reading, a graph to spot trends, and an eight-hour history of your glucose levels.
*The FreeStyle Libre system requires a one-hour warmup period when you first wear the device before you can check your blood glucose levels.
**You may still have to prick your fingers in certain situations including when your symptoms don’t match your CGM readings and when you suspect that the readings may not be accurate.
Difference Between FreeStyle Libre and Other Constant Glucose Monitors
According to the Diatribe Foundation, a company that distributes information about diabetes, another CGM called the Dexcom G6 received Medicare DME approval in early 2019.
Like Abbot’s FreesStyle Libre, Dexcom’s G6 is covered for people on “intensive insulin therapy like multiple daily injections or use of an insulin pump.”
Both devices feature a smartphone app that you can use to closely monitor your blood glucose and manage your insulin treatment. According to Diatribe, Medicare covers CGM smartphone apps “including sharing features.”
The main differences between FreeStyle Libre and G6 are the “warmup periods” and how long you can wear the devices. FreeStyle Libre features a one-hour warmup period, and you can wear the device for two weeks. The Dexcom G6’s warmup period is two hours, and you can wear the device for 10 days.
Who needs constant glucose monitoring?
Diabetic people need constant glucose monitoring because their bodies can’t produce insulin or efficiently use the insulin it makes. Insulin is a hormone that regulates blood sugar levels.
FreeStyle Libre is best for diabetics who use insulin pumps or need multiple insulin injections per day. According to the Mayo Clinic, if you don’t manage diabetes, it may lead to the following complications:
- Cardiovascular disease
- Nerve damage (neuropathy)
- Kidney damage (nephropathy)
- Eye damage (retinopathy)
- Skin conditions such as bacterial and fungal infections
- Hearing problems
- Alzheimer’s disease
Along with managing blood glucose levels, a balanced diet such as the Mediterranean diet, exercising regularly, and maintaining a healthy weight may help prevent type 2 diabetes or manage type 1 diabetes symptoms and complications. Work with your doctor to develop a comprehensive treatment plan.
Find FreeStyle Libre Medicare Coverage
If you have diabetes and you want to learn more about Medicare coverage for FreeStyle Libre, a licensed agent with Medicare Plan Finder can help.
Our agents are highly trained, and they may be able to find plans in your area that cover fitness programs, meal delivery, hearing, and/or routine vision care. To set up a no-cost, no-obligation appointment to discuss your needs, call 1-844-431-1832 or contact us here now.