### Medicare Coverage for Continuous Glucose Monitors and Insulin Pumps If you have type 1 diabetes and are approaching Medicare eligibility, you might be wondering if continuous glucose monitors (CGMs) and insulin pumps are covered. Here's what you need to know: **Medicare Basics** Medicare is a federally-subsidized health insurance program for Americans aged 65 and older, some people with qualifying disabilities, and those with end-stage renal disease or amyotrophic lateral sclerosis. It provides health insurance typically after people retire and are no longer eligible for employer-sponsored health insurance plans. **Medicare Parts** - **Part A**: Hospital insurance - **Part B**: Medical insurance - **Part D**: Prescription drug coverage **Coverage for Diabetes Management** - **Continuous Glucose Monitors (CGMs)**: Covered under Medicare Part B as durable medical equipment (DME). This includes transmitters, sensors, and supplies for most CGM systems. - **Insulin Pumps**: Also covered under Medicare Part B as DME. This includes insulin pumps like Insulet’s Omnipod and Medtronic systems. - **Insulin**: Covered under Medicare Part D, the prescription drug plan. **Medicare Advantage Plans** Medicare Advantage plans (Part C) bundle Parts A, B, and D and may offer additional benefits like vision, hearing, and dental care. These plans must follow Original Medicare’s coverage guidelines. **Enrollment** Medicare coverage starts when you turn 65. You need to enroll to gain coverage. The initial enrollment period begins 3 months before you turn 65 and lasts until 3 months after. Coverage starts on the first of the following month after enrollment. **Recent Changes** - **CGM Coverage**: As of February 2022, Medicare covers all transmitters, sensors, and supplies for Medtronic CGM systems used with their MiniMed insulin pumps. - **Insulin Copayment Cap**: A pilot program caps insulin copayments at $35 per month, potentially saving beneficiaries significant amounts annually. **Advocacy and Future Improvements** Medicare coverage for diabetes management tools has improved due to advocacy efforts. However, there is still room for improvement, and getting involved in advocacy can help ensure comprehensive, quality, and affordable coverage. **Conclusion** If you have type 1 diabetes and are nearing Medicare age, you can access CGMs and insulin pumps through Medicare, but you need to choose your plan carefully and be aware of the rules around medical necessity.