A Note from Susie Adriance, Healthcare Compliance Expert
As Chief Financial Officer and Chief Compliance Officer for a durable medical equipment company, I’ve spent over 10 years helping Medicare patients access continuous glucose monitors. Our company has served more than 12,000 Medicare beneficiaries.
So when I tell you that big changes are coming to Medicare CGM coverage, I’m not repeating something I read online. I’m telling you what I’m watching unfold in real-time from inside the industry.
This article will give you the straight facts about what’s happening, what it means for you, and what you should do now—before the changes take effect.
Looking for general information about Medicare CGM eligibility and coverage? Start with our complete guide first.
What’s Changing: Medicare Competitive Bidding for CGMs
On November 28, 2025, the Centers for Medicare & Medicaid Services (CMS) finalized a major rule change. For the first time, continuous glucose monitors will be included in Medicare’s Competitive Bidding Program.
What Is Competitive Bidding?
In simple terms, competitive bidding is how Medicare tries to save money on medical equipment. Instead of paying a set price to any qualified supplier, Medicare will only contract with suppliers who submit winning bids—essentially, the companies willing to accept the lowest payments.
Here’s what you need to know:
- Implementation Date: January 1, 2028
- Transition Period: 6 months for beneficiaries to switch suppliers
- Expected Contract Suppliers: Approximately 10 companies nationwide (down from hundreds currently)
The Timeline You Need to Know
| When | What Happens |
|——|————-|
| December 2025 | CMS begins supplier awareness program |
| Summer 2026 | Supplier registration and bidding begins |
| Fall 2027 | Contracts awarded, prices announced |
| January 1, 2028 | New program takes effect |
| July 2028 | Transition period ends |
How This Affects You: The 5 Biggest Changes
1. You’ll Rent, Not Own, Your CGM
Current System: You purchase your CGM receiver (like the FreeStyle Libre reader), and Medicare lets you get a replacement every 5 years.
New System: CGMs will be reclassified as “frequent and substantial servicing” items. This means:
- You’ll pay monthly rental fees instead of purchasing
- You won’t own your device
- Suppliers will bill approximately $272.69 per month for CGMs
What This Means for You: On the positive side, you’ll be able to upgrade to newer technology more frequently. On the negative side, you’ll never actually own your equipment.
2. Fewer Suppliers to Choose From
This is where I get concerned as someone who’s been in this industry for a decade.
Current System: Hundreds of DME suppliers across the country can provide your CGM.
New System: CMS expects only about 10 suppliers will win nationwide contracts.
When competitive bidding was applied to diabetic testing supplies years ago, we saw many small and mid-sized suppliers close their doors. Patients lost the local relationships they’d built with suppliers who knew them by name.
My Professional Opinion: A CGM isn’t like ordering test strips. Patients need education, troubleshooting help, and ongoing support. I worry that limiting suppliers to 10 companies may reduce the personalized service seniors deserve.
3. Your Current Supplier May Not Make the Cut
If your current CGM supplier doesn’t win a contract, you’ll have 6 months to transition to a new supplier after January 2028.
Good News: If you have an existing rental agreement when competitive bidding starts, you may be “grandfathered” as a non-contract beneficiary until you need a new device.
4. Monthly Costs Will Change
Under the new system:
- CGM Equipment + Supplies: Approximately $272.69/month
- Your 20% Coinsurance: Approximately $54.54/month (after Part B deductible)
- Suppliers can bill up to 3 months in advance
If you have a Medicare Supplement (Medigap) plan, it may cover your 20% coinsurance. Check with your plan.
5. Brand Choice May Be Protected
If your doctor specifically prescribes a FreeStyle Libre or Dexcom by brand name—and documents that switching would cause you medical problems—your access to that specific brand should be protected.
My Advice: Talk to your doctor NOW about documenting why your specific CGM works for you. Get it in your medical record before 2028.
What’s NOT Changing (For Now)
Let me ease some worries:
✅ Medicare still covers CGMs – The coverage itself isn’t going away
✅ Eligibility requirements stay the same – If you use insulin OR have a history of hypoglycemia, you still qualify
✅ You still pay 20% coinsurance – This hasn’t changed
✅ The devices themselves aren’t changing – FreeStyle Libre and Dexcom aren’t going anywhere
What You Should Do NOW (Before 2028)
1. Get Your CGM Before Changes Take Effect
If you’ve been thinking about getting a CGM and you qualify, now is the time. The current system is simpler, and you’ll have an established relationship with a supplier. Not sure if you qualify? Check your eligibility here.
2. Document Your CGM Needs with Your Doctor
Schedule a face-to-face visit and ask your doctor to document in your medical record:
- Why you need a CGM (not just finger sticks)
- Which specific brand works for you and why
- Any adverse reactions or problems with other devices
This documentation protects your access to your preferred device after competitive bidding begins. If you’re ever denied coverage, this documentation becomes essential for filing an appeal.
3. Ask Your Supplier If They Plan to Bid
Call your current CGM supplier and ask:
- “Do you plan to participate in Medicare’s competitive bidding program?”
- “What will happen to my service after January 2028?”
The companies that care about their patients will give you straight answers.
4. Keep Records of Everything
Start keeping a file with:
- Your CGM prescriptions
- Doctor’s orders
- Supplier contact information
- Any correspondence about your CGM coverage
You may need this documentation during the transition.
Why This Is Happening
I want to be fair to CMS here. They have a job to do—protect the Medicare Trust Fund.
Their reasoning:
- CGM technology is advancing rapidly
- The current 5-year replacement cycle doesn’t keep up with innovation
- Competitive bidding has saved Medicare money on other DME categories
My honest assessment: These are legitimate points. But as someone who’s seen what happened to the diabetic testing supply market after competitive bidding, I’m more than cautiously concerned—I’m worried.
What Happened Last Time: The Blood Glucose Monitor Disaster
This isn’t the first time CMS has applied competitive bidding to diabetes supplies. And the results were devastating for patients.
In 2013, CMS implemented competitive bidding for traditional blood glucose monitors and testing supplies—the finger-stick meters that CGMs are now replacing.
Here’s what actually happened:
The Numbers Tell the Story
- 70% reimbursement reduction for diabetic testing supplies
- Hundreds of suppliers reduced to just 18 national contractors
- Substantial disruption of beneficiary access documented by researchers
- 45% of contracted meters had accuracy problems according to quality studies
What Patients Experienced
I watched this unfold in real-time from inside the DME industry. Patients called us confused and frustrated:
- Poor customer service from overwhelmed contract suppliers
- Companies went out of business that patients had trusted for years
- Patients unknowingly switched to cheaper, less accurate products without understanding the change
- Delays in supply delivery became routine
- Loss of personalized support that smaller suppliers had provided
The Hidden Cost
Here’s what CMS doesn’t advertise: Research published in Diabetes Care found that the competitive bidding reductions were “significantly associated with increased mortality, hospitalizations, and costs.”
Read that again. Increased mortality.
The program may have saved Medicare money on testing supplies—but those “savings” came at a cost that’s hard to measure in dollars. More emergency room visits. More hospitalizations. Worse diabetes management. And yes, lives lost.
Why This Matters for CGMs
A continuous glucose monitor isn’t like ordering test strips. CGMs require:
- Patient education on sensor application and reading interpretation
- Technical support when sensors malfunction or apps won’t sync
- Insurance navigation for coverage questions and appeals
- Ongoing relationship with suppliers who know your history
When hundreds of suppliers were reduced to 18 for blood glucose monitors, patients lost the relationships they’d built with local companies who knew them by name. The national contract winners often couldn’t provide the same level of service.
Now they want to do the same thing with CGMs—but with potentially even fewer suppliers.
My Personal Stake in This Fight
I need to be transparent with you: I was one of the 950,000 people who submitted comments opposing this rule.
Not just as someone who works in the industry—but as someone who has helped over 12,000 Medicare patients access CGMs. I’ve seen how this technology changes lives. I’ve talked to patients who finally understood their blood sugar patterns after decades of struggling. I’ve heard from caregivers whose elderly parents are safer because they get alerts when glucose drops.
I don’t know if my company will survive competitive bidding. I don’t know if the other small and mid-sized suppliers I’ve worked alongside will make it through. But I do know this:
Patients deserve better than what happened with blood glucose monitors. They deserve suppliers who know them, support them, and fight for them.
Whether my company wins a contract or not, I’m committed to giving you the information you need to navigate whatever comes next.
The Industry’s Response
I’m not the only one with concerns. The proposed rule received over 950,000 public comments—one of the highest response rates CMS has seen.
Industry organizations like AAHomecare are urging delays in implementation, citing concerns about:
- Reduced patient access
- Loss of small suppliers
- Quality of service under contracted providers
- Impact on patient choice
CMS finalized the rule largely without changes. But the conversation isn’t over.
Frequently Asked Questions
Will my current CGM supplier still be able to serve me?
Maybe. Only suppliers who win competitive bidding contracts can serve Medicare beneficiaries after January 2028. If your supplier doesn’t win a contract, you’ll need to switch to one that did.
Can I still get a FreeStyle Libre or Dexcom specifically?
Yes, especially if your doctor prescribes it by brand name and documents medical necessity. Competitive bidding affects WHO supplies your CGM and HOW they’re paid—not which brands exist.
Will competitive bidding raise my out-of-pocket costs?
It depends. Under the new monthly rental model, your coinsurance will be calculated monthly. For some patients, this may be comparable to current costs. For others, especially those mid-rental period during transition, costs may temporarily increase.
What if I have Medicare Advantage instead of Original Medicare?
Medicare Advantage plans set their own rules for CGM coverage. Some may follow the competitive bidding program; others may not. Check with your specific plan.
When do I need to worry about this?
The program doesn’t take effect until January 1, 2028, with a 6-month transition period. You have time—but that time should be used to prepare, not to wait.
My Promise to You
I created SeniorCGMSupport.com because I watched my best friend’s mother suffer devastating diabetes complications—two leg amputations before she passed. I couldn’t help her, but I can help you.
As these changes unfold over the next two years, I’ll keep you updated with information you can trust. Not corporate marketing. Not government bureaucrat-speak. Real guidance from someone who’s been in this industry for over a decade and has helped thousands of patients navigate Medicare CGM coverage.
Bookmark this page. I’ll update it as new information becomes available.
Have questions? Email me at susie@seniorcgmsupport.com or call 727-831-3729.
Related Resources
If you’re navigating Medicare CGM coverage, these guides may help:
Getting Started:
- Step-by-Step: How to Get CGM Through Medicare
- Medicare Part B CGM Requirements: Do You Qualify?
- Understanding Your Medicare CGM Benefits Statement
Choosing Your Device:
- FreeStyle Libre 3 vs Dexcom G7 Comparison
- FreeStyle Libre Reader vs App: Which Is Better for Seniors?
- CGM Trend Arrows: What They Really Mean
Managing Your Supplies:
- Medicare CGM Supply Allowance: How Many Sensors Can You Get?
- CGM Supply Reorder Schedule
- Can I Use Expired CGM Sensors?
Financial Assistance:
- State Assistance Programs for Diabetic Seniors
- Low Income Subsidies for Diabetes Supplies
- Charitable Programs for Free Diabetes Supplies
- Veterans Benefits for Diabetes Supplies
Sources
- CMS DMEPOS Competitive Bidding Program Updates
- CMS Finalizes DMEPOS Competitive Bidding Rule – Applied Policy
- Medicare CGM Coverage – Medicare.gov
- HME News – CGM Competitive Bidding Analysis
- Diabetes Care – Impact of Competitive Bidding on Diabetic Testing Supplies – Research documenting associations between competitive bidding reductions and patient outcomes
- AAHomecare Analysis – Competitive Bidding Patient Impact – Industry advocacy organization tracking implementation effects
Last Updated: January 2026
Medical Disclaimer: This article provides general information about Medicare coverage and should not be considered medical or legal advice. Always consult with your healthcare provider and Medicare directly for guidance specific to your situation.
Susie Adriance is the Chief Financial Officer and Chief Compliance Officer at a durable medical equipment company specializing in CGM supplies for Medicare patients. She has over 10 years of experience in the DME industry and has helped more than 12,000 Medicare beneficiaries access continuous glucose monitors
