Michigan Medicare CGM Coverage: Great Lakes State Benefits

If you’re a Michigan senior with diabetes, understanding your Medicare CGM (Continuous Glucose Monitor) coverage options is essential for managing your health effectively. This comprehensive guide breaks down everything you need to know about CGM coverage through Michigan Medicare, including eligibility requirements, costs, and how to get started.

Quick Facts About Michigan Medicare CGM Coverage

• Medicare Part B covers CGMs for eligible beneficiaries in Michigan
• Coverage includes both therapeutic CGM devices and supplies
• Most Michigan seniors pay 20% of the Medicare-approved amount after meeting their Part B deductible
• Both Original Medicare and Medicare Advantage plans in Michigan must cover CGMs

CGM Coverage Eligibility in Michigan

To qualify for CGM coverage through Michigan Medicare, you must meet these requirements:

• Have diabetes (Type 1 or Type 2)
• Test blood sugar 4+ times daily
• Take insulin with at least 3 daily injections
• Adjust insulin doses based on blood sugar testing results
• Have a face-to-face visit with your healthcare provider in the last 6 months

Covered CGM Devices in Michigan

Medicare in Michigan covers these therapeutic CGM systems:

• Dexcom G6
• Dexcom G7
• FreeStyle Libre 2
• FreeStyle Libre 3

Michigan Medicare CGM Costs

Here’s what Michigan seniors can expect to pay for CGM coverage:

• Medicare Part B deductible: $240 (2024)
• 20% coinsurance for CGM devices and supplies
• Monthly supply costs typically range from $10-40 with Medicare coverage
• Supplemental insurance may help cover the 20% coinsurance

Michigan Medicare Advantage and CGMs

Medicare Advantage plans in Michigan must provide at least the same CGM coverage as Original Medicare. Some popular Michigan Medicare Advantage providers include:

• Blue Cross Blue Shield of Michigan
• Priority Health
• HAP
• Humana
• Aetna

How to Get Started with CGM Coverage

Follow these steps to obtain CGM coverage in Michigan:

1. Schedule an appointment with your healthcare provider
2. Confirm you meet Medicare’s eligibility criteria
3. Get a prescription for a therapeutic CGM
4. Choose a Medicare-enrolled supplier
5. Provide necessary documentation

Michigan Diabetes Resources

These organizations can provide additional support:

• Michigan Diabetes Prevention Network
• Michigan Department of Health and Human Services
• American Diabetes Association – Michigan Chapter
• Michigan State Medical Society

Common Questions About Michigan Medicare CGM Coverage

Does Michigan Medicaid cover CGMs?

Yes, Michigan Medicaid (including Healthy Michigan Plan) covers CGMs for eligible beneficiaries who meet similar criteria to Medicare requirements.

Can I switch CGM brands under Medicare?

Yes, you can switch between covered CGM brands, but you’ll need a new prescription and documentation from your healthcare provider.

How often can I get CGM supplies?

Medicare covers CGM supplies every 30 days, including sensors and transmitters when needed.

Tips for Michigan Seniors Using CGMs

• Keep detailed records of your blood sugar readings
• Order supplies early to avoid gaps in coverage
• Check your supplier’s Medicare status regularly
• Stay current with preventive diabetes care visits
• Consider joining a local diabetes support group

Getting Help with Michigan Medicare CGM Coverage

Several resources are available to help navigate your CGM coverage:

• Michigan Medicare/Medicaid Assistance Program (MMAP)
• Local Area Agency on Aging
• Medicare’s toll-free helpline
• CGM manufacturer support services

Conclusion

Understanding your Michigan Medicare CGM coverage doesn’t have to be complicated. With the right information and support, you can access the diabetes management tools you need to maintain your health and independence.