How to Get a Freestyle CGM Through Medicare Part B

Walmart cannot bill Medicare Part B for Freestyle CGM supplies, but you may be able to get them through Medicare in other ways

Walmart is not a Medicare durable medical equipment (DME) supplier for continuous glucose monitors (CGMs), including the Abbott Freestyle Libre and Freestyle Libre 2. This means Walmart cannot submit claims to Medicare Part B on your behalf. However, you can still obtain a Freestyle CGM through Medicare — you will need to use a Medicare-enrolled DME supplier instead, and your doctor must write a prescription that meets Medicare's specific requirements.

The difference matters because Medicare Part B covers CGM supplies only when they come through an approved DME supplier. That supplier handles the paperwork, verifies your coverage, and bills Medicare directly. Buying from Walmart out of pocket and then trying to get reimbursed from Medicare does not work the way many people assume it does.

Key Takeaways

Your doctor must prescribe a CGM and document that you use insulin, because Medicare Part B covers CGMs only for people on insulin therapy.
You must order through a Medicare-enrolled DME supplier — Walmart, pharmacies, and online retailers cannot bill Medicare Part B for CGMs.
Common Medicare-enrolled suppliers include Byram Healthcare, Edgepark, Aeroflow Health, and regional medical equipment companies.
Your out-of-pocket cost depends on your Part B deductible and coinsurance, which varies by your specific plan.
If you cannot find a supplier in your area or have trouble with coverage, your doctor's office can often recommend suppliers they work with regularly.

What Medicare Part B covers for CGM devices

Medicare Part B covers continuous glucose monitors under the category of durable medical equipment. As of 2024, Medicare covers the Abbott Freestyle Libre 2 and certain other CGM systems, but coverage rules are specific. You must be on insulin therapy — either injected insulin or an insulin pump — for Medicare to cover a CGM. If you manage your diabetes with oral medications alone, Medicare Part B will not cover a CGM.

Your doctor must submit a prescription that includes documentation of your insulin use. The prescription also needs to specify the type of CGM and how often you will need sensor replacements. Medicare typically covers one sensor per month, though some people need more frequent replacements depending on their prescription.

How to order a Freestyle CGM through a Medicare supplier

Start by asking your doctor for a prescription for a Freestyle CGM. Your doctor's office should know whether you meet Medicare's insulin requirement and can document it in your medical record. Once you have the prescription, you will need to contact a Medicare-enrolled DME supplier directly.

You can find Medicare-enrolled suppliers in your area by using the Medicare Supplier Directory at dmepos.cms.gov, or by calling 1-800-MEDICARE and asking for suppliers near you who carry CGM devices. When you call a supplier, have your Medicare number, your doctor's name and phone number, and your prescription ready. The supplier will verify your coverage, explain your out-of-pocket costs, and arrange delivery of your first sensor and reader.

The supplier handles all the paperwork with Medicare. You do not need to submit anything yourself. The supplier bills Medicare Part B directly and sends you an invoice for your share of the cost (your deductible and coinsurance).

What you will pay out of pocket

Your cost depends on whether you have met your Part B deductible for the year and what your coinsurance is. Medicare Part B has an annual deductible (currently $240, though this changes yearly) that applies to all Part B services combined. Once you meet the deductible, you typically pay 20% coinsurance for DME, including CGM supplies.

The actual dollar amount varies because the supplier's charge and Medicare's approved amount may differ. A supplier might charge $100 for a sensor, but Medicare's approved amount might be $80. You would pay 20% of the approved amount ($16), not 20% of the supplier's charge. Ask the supplier to give you an estimate of your cost before you place your order.

If you have a Medigap or Medicare Advantage plan, your coinsurance may be lower or covered entirely. Check your plan documents or call your plan's customer service line to confirm what you will owe.

Common Medicare-enrolled CGM suppliers

Several large national suppliers carry Freestyle CGM devices and are enrolled with Medicare. Byram Healthcare, Edgepark, and Aeroflow Health all serve Medicare patients across most states. Many regional medical equipment companies are also enrolled. Your doctor's office may have a preferred supplier they work with, and using that supplier can speed up the process because the office already has a relationship with them.

When comparing suppliers, ask about delivery time (usually 5 to 10 business days), whether they offer automatic refills so you do not run out of sensors, and what their customer service hours are. Some suppliers offer phone support 24/7; others have business hours only. If you travel frequently or have trouble remembering to reorder, automatic refill is worth asking about.

What to do if you cannot find a supplier near you

If the Medicare Supplier Directory shows no suppliers in your area, or if the suppliers listed do not carry Freestyle CGM, call 1-800-MEDICARE and explain the situation. Medicare has processes for people in underserved areas, and the representative may be able to help you locate a supplier that serves your region by mail or phone.

You can also ask your doctor's office to help. Many practices have relationships with suppliers outside your when ready area and can request an exception or arrange for mail delivery. Some suppliers will ship nationwide even if they do not have a local office.

If you are having trouble getting coverage approved, your doctor can appeal a denial or contact Medicare on your behalf. Keep copies of all correspondence, including the denial letter, your prescription, and any documentation of your insulin use.

Why Walmart and other retailers cannot bill Medicare

Walmart and most retail pharmacies are not enrolled as Medicare DME suppliers for CGM devices. Even if Walmart sells Freestyle CGM supplies in its stores, it cannot submit a claim to Medicare Part B. If you buy a CGM from Walmart and try to get reimbursed by Medicare afterward, Medicare will not pay because the purchase did not go through an approved supplier.

This is different from some other medical supplies. For example, you can buy test strips at Walmart and have Medicare reimburse you if you submit the receipt and a prescription. But CGM devices and sensors are classified as durable medical equipment, and that category requires the supplier to be enrolled and to handle billing directly.

Frequently Asked Questions

Do I have to use the supplier my doctor recommends?

No. You can choose any Medicare-enrolled supplier. However, using your doctor's preferred supplier often speeds up the process because the office already has the supplier's fax number and knows their requirements. If you prefer a different supplier, make sure they carry the specific CGM your doctor prescribed and that they serve your state.

What if my doctor prescribed a different CGM brand, not Freestyle?

Medicare covers several CGM brands, including Dexcom and Medtronic Guardian, in addition to Freestyle. Your doctor chooses the brand based on your needs. If you want Freestyle specifically, discuss that with your doctor. They can prescribe it if they believe it is medically appropriate for you.

Can I order sensors online from a pharmacy and have Medicare pay?

Only if the online pharmacy is a Medicare-enrolled DME supplier. Most online pharmacies are not. Check the Medicare Supplier Directory or ask the pharmacy directly whether they are enrolled to bill Medicare Part B for DME. If they are not, Medicare will not cover the purchase even if you have a valid prescription.

What happens if Medicare denies my claim?

The supplier will send you a denial notice explaining the reason. Common reasons include not meeting the insulin requirement, missing documentation, or the prescription being incomplete. You can ask your doctor to resubmit with additional documentation, or you can file an appeal. The denial notice includes instructions for appealing.

Will my Medicare Advantage plan cover Freestyle CGM the same way?

Medicare Advantage plans must cover at least what Original Medicare covers, but they may have different rules about which suppliers you can use or how much you pay. Call your plan's customer service number before ordering to confirm coverage and find out which suppliers are in your plan's network.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.