To get a CGM prescription in the US, schedule a visit with your primary care provider, an endocrinologist, or a telehealth platform that prescribes diabetes technology. Most prescription CGMs (Dexcom G7, FreeStyle Libre 3, Medtronic Guardian, Eversense) are covered by Medicare and commercial insurance for patients with type 1 diabetes or insulin-treated type 2 diabetes. If you do not use insulin and want a CGM without a prescription, Dexcom Stelo and Abbott Lingo are FDA-cleared OTC options.
Step 1: Decide What CGM You Want
Different CGMs have different criteria, costs, and prescriber familiarity. The four main prescription-only CGMs in the US are:
| System | Wear Time | Notable Feature |
|---|---|---|
| Dexcom G7 | 10 days + 12-hour grace | Insulin-pump integration, urgent-low alarm |
| FreeStyle Libre 3 | 14 days | Smallest sensor, 1-min streaming |
| FreeStyle Libre 3 Plus | 15 days | Newest Libre generation |
| Eversense E3 | 180 days (implanted) | Long-term implant; in-office insertion |
| Medtronic Guardian 4 | 7 days | Integrated with Medtronic 780G pump |
Step 2: Choose Your Prescriber Path
Primary care provider (PCP)
Your PCP can write a CGM prescription if you have a documented diagnosis of diabetes or prediabetes. This is the lowest-cost option if you already see a PCP regularly. Bring recent A1C results and your current medication list. Be prepared to discuss why a CGM is medically appropriate (frequent fingersticks, dose adjustments, hypoglycemia, motivation for behavior change).
Endocrinologist
An endocrinologist sees CGMs daily and is most likely to navigate insurance, prior authorization, and pump-CGM integration. Wait times are often 2-6 months for a new patient appointment, but the long-term care quality is high.
Telehealth (cash-pay or insurance)
Several telehealth platforms specialize in fast cash-pay CGM prescriptions:
- Hers / Hims: GLP-1 and metabolic health programs; often bundle CGM with weight management.
- Ro: Diabetes and weight care, including Dexcom and Libre prescriptions.
- 9amHealth: Type 2 diabetes telehealth that ships CGMs and supplies.
- Steady Health: Endocrinologist-led virtual diabetes care with insurance acceptance.
- Mochi Health, Sequence: Weight-care platforms that may add CGM to GLP-1 protocols.
Most cash-pay telehealth visits cost $40-$199 plus the price of the CGM (typically $75-$140 per sensor or $250-$400 per month).
Diabetes-care clinics and DPP programs
The CDC’s National Diabetes Prevention Program and many ADA-recognized education programs can refer participants to clinicians who prescribe CGMs as part of structured care.
Step 3: Insurance Coverage Criteria
According to CMS, Medicare Part B covers CGMs as durable medical equipment for any beneficiary with diabetes who uses insulin or has a history of problematic hypoglycemia. As of mid-2023, the requirement to perform 4+ fingerstick checks per day was removed for many Medicare beneficiaries.
Commercial insurance criteria vary but commonly include:
- Type 1 diabetes
- Type 2 diabetes on multiple daily injections of insulin
- Documented hypoglycemia or hypoglycemia unawareness
- Pregnancy with diabetes
- Recent A1C above goal despite standard fingerstick monitoring
Coverage for non-insulin type 2 diabetes and prediabetes is expanding in 2024-2025 as more payers respond to evidence. Always call your plan or use the formulary tool on the insurer’s website to confirm.
Step 4: Documentation to Bring
- Recent A1C result (within the last 90 days)
- List of current medications, especially insulin types and doses
- Fingerstick log if you have one
- Notes on hypoglycemia frequency or severity
- Insurance card and prior-authorization phone number
Step 5: Filling the Prescription
Once you have a CGM prescription, it can be filled in three places:
- Retail pharmacy: CVS, Walgreens, Walmart, and most independents stock Dexcom G7 and FreeStyle Libre. Convenient for monthly pickup.
- Mail-order pharmacy or DME supplier: Edgepark, Byram Healthcare, and CCS Medical handle insurance billing and ship 90-day supplies.
- Manufacturer direct: Dexcom, Abbott, and Medtronic offer direct-shipping programs, sometimes at a discount for cash-pay patients.
OTC Alternatives if You Cannot Get a Prescription
If you do not use insulin and your insurance does not cover a CGM, two OTC sensors are now available:
- Dexcom Stelo: 15-day wear, $89-$99 per sensor, app readings every 15 minutes
- Abbott Lingo: 14-day wear, $89 per sensor, focused on metabolic health
OTC CGMs are not approved for insulin dosing and lack urgent-low alarms, but they can give you most of the trend data of a prescription CGM at a similar cost. According to the FDA, both Stelo and Lingo are intended for adults age 18 and up.
Common Reasons a Prescription Gets Denied
- Patient does not meet the plan’s insulin or A1C threshold
- Missing prior-authorization documentation
- The prescriber chose a CGM not on the plan’s preferred list
- Quantity requested exceeds plan limits (e.g., more than 90 days at a time)
If denied, ask the prescriber to file an appeal with supporting clinical notes, or switch to the plan’s preferred CGM brand. For more on diabetes detection and care, see the detection of prediabetes guide and the A1C levels hub.
The Bottom Line
To get a CGM prescription, talk with your primary care provider or endocrinologist, or use a fast telehealth route like Ro, Hers, Hims, or 9amHealth. Bring documentation of your diabetes status and insulin use to maximize insurance coverage. If you do not use insulin and want immediate access without a prescription, Stelo and Lingo offer OTC options for around $89-$99 per sensor.
Medical disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider with any questions about a medical condition or medication.
