What to Do When You Can’t Afford a Continuous Glucose Monitor
Navigating diabetes care when CGM costs are out of reach: practical tips, resources, and alternatives.
Continuous glucose monitors (CGMs) have transformed the lives of many people living with diabetes, offering up-to-the-minute data and insights to make blood sugar management safer and more convenient. However, for countless individuals and families, the high cost of CGMs—especially when insurance coverage falls short or is nonexistent—poses a major barrier. This article explores practical steps, programs, and alternative methods for those who struggle to afford a CGM but still need reliable options for managing diabetes.
Understanding the Challenge: The High Cost of CGMs
CGMs use small sensors worn on the body to continuously measure interstitial glucose levels. Data from these sensors can be tracked in real time via smartphones or insulin pumps, helping detect patterns, manage highs and lows, and reduce life-threatening events. Many people, especially those with type 1 diabetes, have come to rely on CGMs, but affordability remains a widespread concern.
- Insurance Limitations: Not all private insurers cover CGMs, and even with coverage, copays, deductibles, or limits on covered brands may leave users with substantial out-of-pocket costs.
- Out-of-Pocket Expenses: The annual cost for CGMs can range from $1,000 to over $5,000, depending on insurance coverage, model, and usage patterns.
- Medicaid and Medicare: While coverage has improved in recent years, variances by state and strict documentation requirements can create hurdles for many.
- Uninsured or Underinsured: For millions without insurance or with high-deductible plans, the full list price for devices and supplies is often prohibitive.
Why CGMs Matter in Diabetes Management
Before considering alternatives, it’s important to recognize what people miss when they go without a CGM, and why access is so critical:
- Real-Time Feedback: CGMs help catch rising or falling blood sugars before they become emergencies. Many CGMs issue alarms for lows or highs.
- Simplified Daily Management: With fewer fingersticks and automatic data tracking, CGMs ease the burden of diabetes care.
- Improved Long-Term Outcomes: Several studies confirm that regular CGM use lowers average blood glucose, reduces severe hypoglycemia, and improves quality of life.
- Data Sharing: Many CGMs allow secure sharing of readings with family or healthcare teams in real-time, offering extra layers of support.
The Cost-Effectiveness Equation
Evidence suggests that, despite upfront costs, CGMs improve clinical outcomes and can be cost-effective for people with poorly controlled diabetes. Still, for those with financial constraints, the reality is that the short-term cash outlay may be impossible to meet, even if long-term health outcomes would benefit.
First Steps: Talk to Your Doctor and Insurance Provider
If you want a CGM but can’t afford one, start by gathering the details on your insurance policy and engaging your healthcare team. These steps may help uncover avenues for coverage or support:
- Request a Prescription: Medical necessity, documented by your doctor, can sometimes move the needle with resistant insurers.
- Review Insurance Details: Check which CGMs are listed on your plan’s formulary, the yearly deductible, and any requirements such as prior authorization or proof of frequent blood sugar testing.
- Appeal Denials: If your claim is denied, work with your healthcare team to file an appeal. Medical letters and documentation of frequent glucose testing or severe hypoglycemia can be critical.
- Check for Medicare and Medicaid: Adults and children who meet certain criteria may have options through these programs, but documentation is key.
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Financial Assistance: Manufacturer Patient Assistance Programs
Nearly every CGM manufacturer maintains patient assistance programs to help low-income or underinsured patients access devices and supplies. These programs often have specific income and insurance qualification thresholds and may provide free or discounted products for a defined period.
- Dexcom: Offers a patient assistance program for applicants who meet income eligibility guidelines.
- Abbott (Freestyle Libre): Provides a savings card, copay assistance, and possible discounted rates directly for those who qualify.
- Medtronic: Maintains a financial assistance office that may be able to provide discounts or help secure funding for eligible individuals.
- Senseonics (Eversense): Offers variable assistance based on need and eligibility.
To apply, visit manufacturer websites directly or speak to customer service. Required documents usually include proof of income, current insurance statements, and prescription information.
Other Avenues for CGM Cost Relief
If insurance and manufacturer assistance fall short, try the following additional resources and strategies:
- Pharmacy and Retailer Discounts: Some large pharmacy chains or big box stores offer discounted pricing for CGM devices and sensors, particularly when bought in bulk or on subscription plans.
- Online and Community Support: Online diabetes communities often share tips about temporary promotions, sample programs, or bulk purchasing options for supplies.
- Charitable Assistance Programs: Several nonprofit organizations offer grants or direct financial assistance for diabetes supplies, including CGMs. Examples include the Diabetes Foundation, PAN Foundation, and some regional diabetes associations.
- Flexible Spending (FSA) and Health Savings Accounts (HSA): These pre-tax accounts, if available, can be used to pay for CGM systems and supplies, reducing personal cost.
- Prescription Discount Cards: Some cards can reduce copays for diabetes supplies at participating pharmacies.
What to Do Without a CGM: Practical Alternatives
If you are unable to access a CGM, conventional blood glucose monitoring remains a reliable, if more time-consuming, alternative. Here are key strategies for optimizing control with traditional self-monitoring:
- Frequent Fingersticks: Check blood glucose multiple times a day, especially before and after meals, before driving, during exercise, and at bedtime.
- Log Your Data: Use a paper notebook, glucose meter software, or a mobile app to log numbers, meal times, medication dosages, symptoms, and activity. Trends become clearer over days or weeks.
- Structured Testing Days: Periodically do ‘profile’ days where you check more frequently (e.g., fasting, before and 2 hours after meals, at bedtime, and overnight) to uncover hidden patterns.
- Hypoglycemia Awareness: Learn to recognize symptoms (shakiness, sweating, confusion) and always carry quick sources of sugar.
- Engage with Your Care Team: Share your logs with your healthcare provider to adjust medication, diet, or activity plans promptly.
Budgeting Tips for Test Strips and Supplies
- Generic Brands: Consider FDA-approved generic test strips or less expensive meter-strips combinations for routine checks.
- Bulk Purchasing: Some retailers offer discounts for buying larger packs of test strips.
- State or Local Assistance: Some health departments or public clinics distribute free or reduced-cost test strips and meters.
Community and Support Resources
Financial strain and frequent management tasks can be isolating, but community resources provide education, emotional support, and sometimes direct material aid.
- Online Patient Communities: Groups such as Beyond Type 1, diabetes.org forums, and social media groups offer lived experience and resource sharing.
- Local Diabetes Education Programs: Hospitals, clinics, and nonprofit organizations often offer free or sliding-scale classes and peer support groups.
- Health Department Community Clinics: Some provide case management, free or reduced-cost supplies, and screening.
The Role of Health Policy and Advocacy
Inequitable access to diabetes technology remains a significant public health concern. Advocacy groups continue to work for better coverage, lower costs, and greater transparency. You can add your voice by:
- Joining letter-writing or social media campaigns aimed at lawmakers or insurers.
- Participating in patient panels or advocacy organizations such as JDRF, American Diabetes Association, or Diabetes Patient Advocacy Coalition (DPAC).
- Sharing personal stories with policymakers to highlight barriers and the need for more inclusive policies.
Frequently Asked Questions (FAQs)
Is there a way to get a CGM for free?
Some manufacturers and charities provide free CGM sensors or starter kits for new users who qualify based on financial need. Application processes require proof of income and prescription documentation. Periodic promotions may also offer discounted or no-cost starter kits through health systems or direct partnerships. Check manufacturer patient assistance programs and ask your healthcare provider if they know of any current offers.
How often do I have to check my blood sugar if I don’t have a CGM?
If you’re relying on fingersticks, most people with insulin-dependent diabetes check at least 4-6 times per day, and sometimes more depending on activity, illness, or symptoms. You may need to do extra checks before driving, when exercising, or if you have symptoms of low or high blood sugar. Work with your healthcare provider to find an appropriate schedule.
What are some tips for managing diabetes with limited resources?
- Use generic or store-brand test strips when possible.
- Apply for manufacturer or charitable assistance programs.
- Seek community clinics and nonprofit organizations that provide diabetes education and sometimes free supplies.
- Prioritize frequent blood sugar testing at critical times even if you must space out testing.
- Track your readings, food intake, exercise, and medications carefully to catch patterns early.
Where can I find emotional support when struggling with diabetes management costs?
- Online diabetes communities such as Beyond Type 1, forums at diabetes.org, and social media support groups.
- Local hospital or health department-run diabetes classes or peer support groups.
- One-on-one counseling with social workers, case managers, or diabetes educators.
Summary Table: CGM Affordability Tips
| Strategy | Description |
|---|---|
| Check Insurance | Review your plan details, contact your insurer, and file appeals if necessary. |
| Manufacturer Assistance | Apply to patient assistance programs or request copay cards directly from device makers. |
| Community and Nonprofits | Seek grants, free supplies, or advice from diabetes organizations or local clinics. |
| Alternative Monitoring | Use regular fingerstick monitoring, structured logging, and optimize by tracking patterns. |
| Budgeting | Buy supplies in bulk, use generics, or utilize flexible savings accounts for medical purchases. |
Final Thoughts
Living with diabetes presents daily challenges, complicated further by cost barriers to important diabetes technology. If you cannot afford a continuous glucose monitor, know that you still have options to manage your health, obtain support, and advocate for change. Lean on your care team, seek out assistance programs and community support, and remember that regular self-monitoring—though imperfect—is always better than going without. With persistence, education, and support, safe and effective diabetes care is possible for everyone.
References
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5961392/
- https://www.healthline.com/health/type-2-diabetes/how-to-pay-diabetes-tech
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9659662/
- https://diabetesjournals.org/clinical/article/43/3/399/158023/Impact-of-Continuous-Glucose-Monitoring-Sourcing
- https://diabetes.org/tools-resources/managing-diabetes-costs/cost-access-diabetes-technologies
- https://diabetes.org/advocacy/cgm-continuous-glucose-monitors
- https://www.health.harvard.edu/blog/is-blood-sugar-monitoring-without-diabetes-worthwhile-202106112473
- https://www.pcmg-us.org/toolkit/cgm
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