How Often Will Medicare Replace My CGM?

Understanding Medicare CGM replacement frequency is crucial for seniors managing diabetes. Medicare has specific guidelines about how often they’ll replace your Continuous Glucose Monitor (CGM) and its components to ensure you maintain accurate blood sugar readings.

Quick Answer: Medicare typically replaces CGM transmitters every 90 days and sensors every 30 days. The receiver/display device is usually replaced every 5 years, assuming normal wear and tear.

 A Note from Susie Adriance, Healthcare Compliance Expert                                                                                          

 As Chief Compliance Officer for a DME company, I can tell you exactly what Medicare allows—and what most patients don’t realize they’re entitled to.                                                                            

  After 10+ years of helping 12,000+ Medicare patients navigate CGM coverage, I’ve seen too many seniors running low on sensors because they didn’t understand the replacement rules. Let me clear this up once and for all.                     

Medicare CGM Replacement Schedule: What You Need to Know

Medicare’s replacement schedule for CGM components depends on the specific part and your individual needs. Let’s break down the replacement timeline for each component:

CGM Component Replacement Schedule

• Sensors: Every 30 days (monthly supply)
• Transmitters: Every 90 days (quarterly)
• Receivers/Display Devices: Every 5 years
• Adhesive patches, if needed: Monthly supply

Pro Tip: Mark your calendar for replacement dates and order supplies 7-10 days before you need them to avoid gaps in monitoring.

How to Get Your Medicare CGM Replacement

Follow these steps to ensure timely replacement of your CGM components:

1. Contact your healthcare provider for a new prescription
2. Choose a Medicare-approved supplier like Senior CGM Support
3. Verify your Medicare coverage is current
4. Schedule regular follow-up visits (required every 6 months)

2025 Medicare Update: Coverage criteria now includes both Type 1 and Type 2 diabetes patients using insulin or with documented problematic hypoglycemia.

What If Your CGM Breaks Early?

Sometimes CGM components fail before their scheduled replacement date. Medicare may cover early replacement if:

• Your device malfunctions and cannot be repaired
• You have documentation from your healthcare provider
• The supplier confirms the device is defective
• You haven’t lost or damaged the device through misuse

 Expert Tip from Susie Adriance                                                                                                                                                                                                                                                            

 Pro tip I share with every patient: Set a reminder to reorder 7-10 days before you run out. Medicare allows regular replacements, but shipping delays happen. I’ve seen patients go without sensors because they waited until the last minute. Plan ahead—your health depends on it.       

Important Medicare Requirements

To continue receiving CGM replacements, you must:

• See your doctor every 6 months for diabetes management
• Use your CGM regularly (Medicare requires data showing consistent use)
• Keep your prescriptions current (update annually)
• Maintain Medicare Part B coverage with paid premiums

Tips for Smooth CGM Replacements

Order Supplies Early

Contact your supplier when you have 2 weeks of supplies remaining. This prevents gaps in your glucose monitoring.

Keep Records

Document when you receive new supplies and note any issues with your devices. This helps if you need early replacement.

Stay Connected

Make sure your supplier has your current contact information. Many offer automatic shipment programs for convenience.

Know Your Rights

If Medicare denies your replacement request, you have the right to appeal. Ask your supplier for help with the appeals process.

Common Questions About CGM Replacement

Can I get extra sensors if I travel? Medicare typically only covers a 30-day supply at a time. Plan ahead and order before traveling.

What if my skin is sensitive to adhesives? Medicare may cover barrier wipes or alternative adhesive products with proper documentation from your doctor.

Do I need a new prescription for replacements? Your initial prescription usually covers a year of supplies, but you’ll need renewal annually.

When to Contact Your Supplier

Reach out to your CGM supplier when:

• You’re down to your last week of sensors
• Any component stops working properly
• You need to update your shipping address
• Your Medicare coverage changes
• You have questions about your replacement schedule

This content is for informational purposes only. Always consult your healthcare provider for medical advice and Medicare for specific coverage details.

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