CGM system covered?

[vic120]

I have a woman who wants this covered Dexcom G7, or something similar
its a a CGM system, that delivers real-time glucose readings

I had thought that Ins or a least at one time did not cover these as not medically necessary but she tells me her current group employer coverage pays for it, So I was wanting to know if this has changed?

 

[Jim Wright]

Depends on the carrier but you can find them on the formulary. I know in NC Aetna and BCBS NC both cover that Dexcom device.

 

[vic120]

Depends on the carrier but you can find them on the formulary. I know in NC Aetna and BCBS NC both cover that Dexcom device.

So it is only some carriers I am looking BCBS in TX mainly on this one

I cant look it on on health sharper like meds right?

 

[Jim Wright]

So it is only some carriers I am looking BCBS in TX mainly on this one

I cant look it on on health sharper like meds right?

I don't think so. I haven't been able to get those to come up on Sherpa. And I typically don't look at Sherpa for meds because it seems to be pretty inaccurate and they never show tiers.

I'm usually going to the formulary and checking manually if it's a drug or something I don't know well