CGMs - getting them for patients

CU Anschutz Page - "How to" for Medicaid patients

Aaron Brown, the FMC pharmacist. can help.

He has had success with sending a CGM (DEXCOM 7 or other) to US Med. They require patients to have an account, which Aaron has helped set up. Then they perform a "benefit check" to make sure insurance looks good. After that they create a patient-specific order form that they fax to us to fill it out. 

From FEJ:

As some of you may already know, Byers Pharmacy in Colorado is set up to process CGMs for Colorado Medicaid and most commercial insurances, but I had issues with a TriCare pt.  (UPDATE: BYERS CURRENTLY NOT WORKING 10/2024). 

I recently found Wellstart Pharmacy in Port St Lucie, FL that was able to quickly figure out the insurance process for my TriCare patient AND I was able to speak with a human immediately when I called. They processed the case the next day and pt received CGM a week later. I would highly recommend this pharmacy since they specialize in this process and cover most insurances.

General overview on who might qualify for CGM:

• Be diagnosed with diabetes type 1 or type 2

• Use a blood glucose monitor (BGM)

• Test your blood sugar four or more times per day

• Use multiple daily injections of insulin or use a constant subcutaneous infusion (CSI) pump

• Require frequent insulin adjustments

• Completed formal diabetes education 

last updated 10/2024, KAI.