How Much Does Dexcom CGM Cost?

Last Updated on June 19, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

For people with diabetes, continuously monitoring blood glucose levels offers invaluable health insights. But this advanced technology comes at a price. So, what is the cost for a Dexcom continuous glucose monitoring (CGM) system?

With insurance coverage, out-of-pocket costs may be considerably less. But the expenses add up for this lifesaving monitoring technology.

How Much Does Dexcom CGM Cost?

The retail price for a Dexcom CGM runs from $799 for a one-time hardware purchase up to $399 per month for their subscription model. The disposable sensors required for monitoring retail for around $80 each.

The complete Dexcom CGM monitoring system consists of three key components:

Sensors – $80 retail per unit

The disposable sensors are inserted under the skin and capture glucose level data. They must be replaced every 10-14 days.

Transmitter – $400 retail one-time purchase

The reusable transmitter sends data wirelessly from the sensor to a display device. It lasts approximately 3 months before needing replacement.

Receiver or Mobile App – $0 to $899 retail

A dedicated touchscreen receiver or compatible smart device app receives the CGM data and displays it for analysis. Apps have no cost while standalone receivers range from $0 to $899 depending on the model.

According to Dexcom’s website, the cost of their Dexcom G7 CGM system can vary significantly depending on a person’s insurance coverage and eligibility. For those with commercial insurance, the out-of-pocket cost can be as low as $20 per month. Dexcom also offers a pharmacy savings program that can help reduce the cash price of their CGM systems by over 50%.

The Verge reports that for those without CGM coverage, Dexcom CGMs can cost around $173 per month out of pocket. However, Dexcom’s website states that their patient assistance program offers discounts to eligible US residents who meet certain income criteria.

Healthline provides a more detailed breakdown of the average monthly costs for CGM systems, including Dexcom. They estimate that the total annual cost for a Dexcom G6 system can range from $4,173 to $6,000, or $347 to $500 per month, without insurance coverage.

Why Does The Dexcom CGM Matter?

Let’s review what CGM is and why it’s important for diabetes:

• Uses a tiny sensor inserted under the skin to continuously track glucose levels rather than periodic finger sticks alone.
• Readings are sent automatically every 5 minutes to a receiver device or compatible smart device app.
• Enables real-time glucose trend tracking and customizable alerts for high/low levels before they become critical.
• Allows for much tighter glucose control and precise dosing adjustments of insulin or medication in response to the data.
• Significantly reduces the risk of hypoglycemia episodes and associated dangers like seizures, loss of consciousness, or death.
• Provides invaluable time-in-range and reporting data to inform treatment plans and lifestyle adjustments.

While certainly not cheap, CGM delivers considerable benefits that make the investment worthwhile for many people with diabetes.

Monthly and Yearly Costs of Dexcom CGM

With the required regular sensor replacements and annual transmitter costs, typical recurring expenses are:

• $299 per month – Assumes $80 sensors changed every 10 days plus 1/3 the cost of an annual transmitter.
• $3500 per year – Includes $960 ($80 x 12) in sensors for the year and one $400 transmitter.

The receiver or app represents a one-time hardware purchase that may be covered fully or in part by insurance. These costs illustrate the significant ongoing investment associated with CGM technology – hence the need for proper financial planning.

Factors Impacting Dexcom CGM Pricing

Several important considerations affect how much you’ll pay out of pocket for CGM equipment and supplies:

• Insurance Coverage – Whether CGM costs are covered and to what extent depends entirely on the plan details and deductible terms.
• Pharmacy/Supplier Discounts – Those with special negotiated pricing often offer sensors for lower retail rates around $75 each rather than $80.
• Manufacturer Discounts – Pharmaceutical company discount programs can reduce copays and supply costs significantly.
• Purchase Source – Buying directly from retail pharmacies is often most expensive. Ordering online from verified suppliers offers savings.
• Insurance Reimbursement – Seeking claim reimbursement from insurers yields the maximum coverage but requires diligence.

Understanding your medical insurance plan specifics along with utilizing discounts and reimbursement allows you to minimize your Dexcom CGM expenses.

Cost Saving Tips for Dexcom CGM

Here are some smart ways to reduce your CGM costs:

• Use manufacturer coupons and discount offers to get sensors for free or at a reduced rate when purchasing transmitters.
• Buy Dexcom sensors in discounted multi-packs of 3 or 5 rather than paying full price individually.
• Use flexible spending (FSA) and health savings (HSA) accounts to pay CGM expenses with pre-tax dollars.
• Enroll in smartphone prescription savings apps which offer coupons and instant rebates at major pharmacies.
• Purchase sensors and transmitters from verified online medical supply distributors which tend to offer lower prices and bulk discounts compared to physical pharmacies.
• Consider CGM prescription renewal and insurance support services that handle all the paperwork and claims processing for you.
• Apply for financial assistance programs like those from the JDRF organization if facing hardship.

Every dollar saved makes this critical health monitoring technology more financially accessible.

You might also like our articles about the cost of HSG tests, Exogen bone healing system, or tuberculosis tests.

Dexcom G6 vs. G7 – Cost Difference

Dexcom’s latest model, the G7, awaits FDA approval but promises major hardware enhancements:

• 60% smaller, all-in-one disposable sensor/transmitter rather than separate components.
• Entirely factory-calibrated sensors, eliminating the need for routine finger stick calibrations.
• Acetaminophen blocking that prevents false high readings caused by medication.

As a next generation system, the G7 will likely retail for around 20-30% more than the G6 based on current CGM pricing trends. But increased competition may keep costs in check. Time will tell.

Does Insurance Cover Dexcom CGM?

The majority of private health insurance plans and government programs like Medicare provide at least some coverage for CGM technology:

• The extent of coverage depends on deductibles, premiums, copays, equipment classifications, and other plan details.
• Preauthorization may be required so it’s critical to check with your provider.
• Those with coverage must obtain explicit confirmation of coverage terms from their insurer before purchasing supplies.
• Keep all product receipts and documentation for submitting reimbursement claims.

While largely covered by insurance, understanding any exclusions in your specific policy ensures you receive maximum benefits for CGM costs.

Final Words

While representing a substantial investment, Dexcom CGM provides life-changing benefits for effectively managing diabetes health. Expect to spend around $300 monthly or over $3500 annually for sensors and transmitters without insurance coverage.

However, utilizing medical insurance, discount programs, and savvy purchasing strategies can reduce real-world out-of-pocket costs considerably. Compare your options so you can fit this important health monitoring technology into your diabetes care budget.

Frequently Asked Questions

What is the 20% rule for Dexcom G6?

Dexcom G6 readings within 20% of a blood glucose meter value are considered accurate and clinically safe for making treatment decisions. Larger variations may indicate the need for sensor replacement or finger stick confirmation. This 20% accuracy standard helps ensure reliability.

How often can you bill for CGM?

For insurance billing purposes, CGM sensors are considered single-use disposable devices and can only be billed once per 10–14-day sensor life. However, early sensor failures or losses can sometimes be appealed with documentation from your provider stating medical necessity for more frequent replacements.

Does Dexcom require a subscription?

Dexcom offers flexibility – you can either purchase CGM hardware outright or use their subscription model. The subscription provides sensors, a transmitter, and access to support services for a monthly fee. There’s no mandatory subscription to use Dexcom, but it provides convenience and potential savings for frequent users.