How Much Does a CGM Cost? A Breakdown of All Expenses

Continuous Glucose Monitoring (CGM) systems offer a significant advancement in diabetes management, providing real-time glucose readings throughout the day and night. This technology eliminates the need for frequent fingerstick tests, offering a more comprehensive view of glucose trends and patterns. For many individuals living with diabetes, a CGM can be an invaluable tool for making informed decisions about diet, exercise, and medication adjustments. Understanding the financial aspects of these devices is a common concern, and this article aims to clarify the various costs associated with CGM systems.

Understanding CGM Components and Their Costs

A typical CGM system comprises several components. The sensor, a small electrode inserted under the skin, measures glucose levels in the interstitial fluid. These sensors are disposable and require regular replacement, usually every 7 to 14 days. Without insurance, individual sensors can cost approximately $37 to over $200, depending on the brand and model. Annually, sensor costs alone can reach $3,000 to $4,800 for some systems.

Another component is the transmitter, which attaches to the sensor and wirelessly sends glucose data to a display device. Transmitters are reusable and need replacement every 3 to 12 months. For example, a Dexcom G6 transmitter lasts about 90 days and can cost around $366 without insurance, leading to an annual cost of $1,100 to $1,200. Some newer CGM models, such as the Dexcom G7, integrate the transmitter directly into the disposable sensor, simplifying the system but combining costs.

The third component is the receiver or display unit, which presents the glucose readings. This can be a dedicated handheld device or a compatible smartphone application. While using a smartphone can eliminate the need for a separate receiver, a dedicated receiver can cost between $499 and $700 if purchased without insurance. This is a one-time purchase, unlike the recurring costs of sensors and transmitters.

Impact of Insurance Coverage

Health insurance plays a major role in determining out-of-pocket expenses for CGM systems. Coverage varies depending on the type of insurance plan, including private health insurance, Medicare, and Medicaid. Many commercial insurance plans cover a portion of CGM costs, with some individuals reporting $0 out-of-pocket for certain systems. The amount paid depends on their plan’s deductible, co-pay, and co-insurance.

Medicare Part B may cover continuous glucose monitors and associated supplies for eligible individuals with diabetes. To qualify, individuals need a diabetes diagnosis, a medical necessity for daily blood sugar testing, and either insulin use or a history of problematic low blood sugar. After meeting the annual Part B deductible, which is $257 in 2025, Medicare covers 80% of the approved amount, leaving the individual responsible for a 20% co-insurance. Medicare Advantage plans must offer at least the same coverage as Original Medicare, but their premiums, deductibles, and co-payments can vary.

Medicaid coverage for CGMs varies by state. While most states offer CGM coverage, eligibility criteria can differ, with some states limiting coverage to specific types of diabetes or age groups. A federal mandate, the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, ensures that children under 21 on Medicaid can access CGMs if medically necessary, regardless of state-specific adult policies. The classification of CGM supplies under a medical benefit (durable medical equipment) versus a pharmacy benefit impacts access and cost, with pharmacy benefits often offering faster approvals and lower out-of-pocket expenses.

Key Factors Influencing CGM Prices

Several variables contribute to CGM system prices. The specific brand and model of the CGM system can lead to price variations. Without insurance, annual costs for a CGM system can range widely, from under $2,000 to as high as $7,000, depending on the manufacturer and technology. For instance, FreeStyle Libre systems are more affordable without insurance, costing around $2,000 annually, compared to some Dexcom systems reaching $5,000 to $7,000 per year.

The channel through which a CGM system and its supplies are purchased impacts the final price. Prices for the exact same sensor differ between various retail pharmacies, ranging from $37 to over $100. Membership-based pharmacies, such as Costco, often offer lower prices for CGM supplies. Purchasing directly from the manufacturer versus a retail pharmacy or medical equipment supplier presents different pricing structures. Geographical location also influences pricing, with urban areas offering more competitive rates due to a higher concentration of providers and pharmacies.

Strategies for Reducing CGM Expenses

Individuals seeking to lower their out-of-pocket CGM costs have several strategies. Exploring manufacturer patient assistance programs (PAPs) can provide financial relief. Companies like Dexcom offer programs that reduce or eliminate costs for eligible individuals, particularly those with Type 1 diabetes who meet specific income criteria and are not on government insurance plans. Similarly, Abbott provides free 14-day sensor and reader vouchers for their FreeStyle Libre systems to qualifying users. Medtronic and Eversense also offer various financial assistance and discount programs.

Utilizing discount cards and coupon programs leads to savings. Services like SingleCare, GoodRx, and RxLess offer coupons that apply at pharmacies to reduce the cash price of CGM sensors and transmitters. Dexcom, for example, offers savings cards that provide over 50% off the standard cash price of their CGM products. Comparing prices among different pharmacies is an effective strategy; calling around or using price comparison applications reveal price discrepancies for the same supplies. Understanding the specifics of one’s insurance plan, including deductibles, co-pays, and whether CGM supplies are covered under a medical or pharmacy benefit, is essential for optimizing coverage and minimizing expense.