The JDRF Artificial Pancreas Project  > Insurance Coverage > CGM Coverage Policies for Select Health Plans


Following is a list of CGM coverage policies for select health plans.  If you do not see your health plan listed here and would like to know if your plan covers CGM, click here. 

CGM Coverage Policies for Select Health Plans*:

• Aetna - Covers all patients with type 1 diabetes over age 25 and those under 25 with recurrent severe hypoglycemia
• Blue Cross Blue Shield of MA - Effective June 1, 2009, covers type 1 with recurrent unexplained severe hypoglycemia or patients who are type 1 and are pregnant.
• Blue Cross Blue Shield of IL - Coverage for type 1 diabetes patients ages 25 and over (Search for "Continuous or Intermittent Monitoring of Glucose in Interstitial Fluid" on the policy site)
• CIGNA - Coverage for type 1 at 25 years of age and older; type 1 under 25 years and have recurrent severe hypoglycemia
• Group Health (WA) - No formal coverage
• Harvard Pilgrim (MA) - Effective April 1, 2009 coverage for continuous glucose monitoring systems.  Additional information for Providers is available here.
• Highmark Blue Cross Blue Shield (PA) - Patients with type 1 diabetes with recurrent severe hypoglycemia or hypoglycemia unawareness
• Horizon Blue Cross Blue Shield (NJ) - No formal coverage
• Humana - Patients with type 1 diabetes with recurrent severe hypoglycemia or hypoglycemia unawareness
• Kaiser Permanente Northern and Southern CA - Covers patients with type 1 diabetes
• Tufts (MA) - Covers patients with type 1 diabetes with hypoglycemia unawareness
• United - Covers patients with type 1 diabetes who have not achieved optimum control or have experienced hypoglycemica unawareness (Search for "Continuous Glucose Monitoring" on the policy site)
• Wellpoint/Anthem - Coverage for type 1 at 25 years of age and older; coverage for all other ages with recurring severe hypoglycemia

*Note: This list describes policies for what is sometimes called "long-term" use of CGM.  Many other plans cover CGM use for 72 hours or less.

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