CGM Followup

My previous post was a rant about my latest issue with insurance and the American healthcare system. The gist of it is I’m losing my Dexcom CGM because Cigna changed their requirements for coverage so that type 2 diabetics need to be severely diseased to qualify. Since it’s something that has likely saved my life while on what I consider to be a dangerous basal insulin, and I’m now working on dietary changes that affects my diabetic health, I’m not willing to easily drop this technology from my life.

So I explored my options.

Freestyle Libre 2 is cheaper than Dexcom G6. I had heard this in the past, but didn’t realize that, at worst, it’s about half the cost on average over 3 months of usage. I use this metric because Dexcom G6 has 2 components, one of which you purchase monthly, the other every 3 months, while Libre 2 is 1 component. The end that I was able to achieve was far better than I expected.

Now, I speculated Cigna was not going to cover ANY CGM for me, but I saw someone note that some providers going this route will be more willing to approve a “flash” CGM. I hadn’t seen how Libre 2 worked and never heard of a “flash” CGM, so this was foreign to me. As it turns out, Libre 2 is a flash CGM, and what this means is it doesn’t send to your reading device constantly like Dexcom does. Typically, a dedicated reader is used and it uses NFC for communication. But the communication is pretty standard so you can link it to a phone and use the phone for scanning.

But that’s a pretty moot point. Cigna rejected coverage of the Libre 2.

Before talking to my pharmacist, I was able to find Libre 2 for about 1/3 of the price that I could find Dexcom G6. However, my pharmacist pulled a “hold my beer” and, through them, my cost for 3 months of Libre 2 sensors is about half of 1 month of Dexcom G6 on average.

While the cost is still higher than the insurance coverage would be, it’s now manageable. It’s at a point that I think it’s worth it to continue to be able to keep track of my diabetic health and my dietary change progress. It’ll cost me about twice as much as it would under insurance coverage, but I’m in a situation where I can bear that.

So I’m switching to the Freestyle Libre 2. The Libre 3 is supposed to release later in the year and it is supposed to function in a more familiar way. I may wait to switch so those who could really benefit from it get first in line, but I will switch to it.

I’m going to miss being able to log my own data. Dexcom allowed me to send my data outside of the Dexcom ecosystem. I used it with Sugarmate on my iPhone, and I was able to plug Home Assistant into it and log the data to Influxdb. That goes away. There’s apparently a third party device I can get that might help expose this data, but I’ll investigate it later, and it may be a moot point when the next generation of CGMs come out.

If Dexcom G7 becomes price competitive with Libre 3, I might switch back. We’ll see.