Medicare Advantage members must obtain continuous glucose monitor products through pharmacies, starting Oct. 1

For dates of service on or after Oct. 1, 2024, Medicare Plus Blue℠ and BCN Advantage℠ members must obtain their continuous glucose monitor products through a participating network pharmacy. 

Blue Cross Blue Shield of Michigan and Blue Care Network will no longer cover CGM products dispensed by contracted and noncontracted durable medical equipment, or DME, suppliers for Medicare Advantage members.

Note: UAW Retiree Medical Benefits Trust members are excluded from this change. These members should continue to purchase their CGM products through a DME supplier.

What’s changing

When this change goes into effect on Oct. 1:

• Medicare Plus Blue and BCN Advantage members who receive their CGM products through a DME supplier will require a new prescription to be filled at a pharmacy.
• Participating pharmacies will be able to dispense CGM products through members’ Part B benefits at point of sale; FreeStyle Libre and Dexcom are the preferred brands. The CGM products will be billed under the members’ medical benefits, not their pharmacy benefits.

Note: Current coverage criteria will still apply.

Additional information

We’ll notify affected members of these changes and encourage them to talk with their health care providers about getting a new prescription before Oct. 1, if needed, and to discuss any concerns.

We’ll update our provider manuals and related documents by Oct. 1 to reflect this change.