How to get Freestyle Libre 2 Supplies
If you’re looking into getting a Freestyle Libre 2 CGM, this all-important post teaches you everything you need to know on the process. And it will save you from pulling your hair out in a fit of frustrated rage.
It's important to know what to look for and ask when getting a CGM. We want to provide you with the equipment you need quickly, so you can feel more confident managing your diabetes.
In this post, we will be covering:
The benefits of using a Freestyle Libre 2
How to check your insurance benefits for coverage of Freestyle Libre 2 Reader and Freestyle Libre 14 Day Sensors
Getting the Freestyle Libre 2 System
What to do after you receive your Freestyle Libre 2
As a board certified diabetes care and education specialist who has worked with 100’s of clients on getting their Freestyle Libre 2 covered and delivered, you’re in the right place.
What is the Freestyle Libre 2 Continuous Glucose Monitor?
People with diabetes use the Freestyle Libre 2 to monitor their blood glucose levels more effectively.
It consists of a small sensor that is placed on the skin of the upper arm and it measures glucose levels continuously throughout the day and night. Users can scan the sensor with a compatible reader or smart phone app to obtain real-time glucose readings, trends, and real time glucose alarms.
This technology empowers individuals to make informed decisions about their diabetes management and can help lower your average blood sugars.
Checking Insurance Benefits and Getting a Prescription for the Freestyle Libre 2
This can be the most time consuming and intimidating part of the whole process. The Freestyle Libre 2 will require a prescription for your health care provider. It can be easy for people with diabetes to get this from their primary care or endocrinologist who manages their diabetes.
As for insurance coverage, that can be the difficult part. But I’m here to navigate it with you!
Typical requirements for CGM insurance coverage
Majority of insurance plans will have specific requirements in place in order for an individual to qualify for coverage of a CGM like a Freestyle Libre 2. Most commercial insurances take their lead from Centers for Medicare and Medicaid Services (CMS) who sets the requirements for Medicare plans.
CGMs and related supplies are covered by Medicare when all the following initial coverage criteria (1-5) are met:
The beneficiary has diabetes mellitus; and,
The beneficiary’s treating practitioner has concluded that the beneficiary (or beneficiary’s caregiver) has sufficient training using the CGM prescribed as evidenced by providing a prescription; and,
The CGM is prescribed in accordance with its FDA indications for use; and,
The beneficiary for whom a CGM is being prescribed, to improve glycemic control, meets at least one of the criteria below:
The beneficiary is insulin-treated; or,
The beneficiary has a history of problematic hypoglycemia with documentation of at least one of the following:
Recurring low blood sugar events (glucose <54mg/dL (3.0mmol/L)) that continue even after trying different medications and adjusting the diabetes treatment plan.
A history of one level 3 hypoglycemic event (glucose <54mg/dL (3.0mmol/L)) characterized by altered mental and/or physical state requiring third-party assistance for treatment of hypoglycemia.
Within six (6) months prior to ordering the CGM, the treating practitioner has an in-person or Medicare approved telehealth visit with the beneficiary to evaluate their diabetes control and determine that criteria (1-4) above are met.
It's important to know the specific requirements of your health plan to make the process faster and (a little) less painful.
Questions to ask the insurance company about Freestyle Libre 2 coverage
Your best bet is going to be calling your insurance company to inquire about coverage. Just use the phone number on the back of your insurance card and you will be connected to a representative. Here are some questions to ask while you are on the phone:
Is a continuous glucose monitor (CGM) covered under my insurance plan?
Are there specific requirements or criteria I need to meet to qualify for CGM coverage?
This could be a number of insulin injections, hypoglycemia episodes, or type of diabetes diagnosis. Make sure these are documented in your health care provider’s prescription and office visit notes when you find them out.
Do I need a prescription from a healthcare provider to obtain a CGM?
Confirm whether a prescription is required and if it needs to come from a specific type of healthcare provider (MD, NP, PA, etc)
What is the minimum frequency for checking blood glucose levels using a CGM to maintain coverage?
Determine how often you should use the CGM to meet coverage requirements (e.g., at least four times a day).
Are regular in-person visits with a healthcare provider necessary for CGM coverage, and if so, how often?
Determine whether you require regular consultations with your healthcare professional to evaluate your diabetes control using CGM data.
Is the CGM classified as durable medical equipment (DME) under my policy or does it fall under pharmacy benefits?
This will determine whether you can get this from a pharmacy or through a DME company.
If covered under medical benefits as durable medical equipment:
Ask what DME companies are in network
You should ask about your deductible and how much you've paid. You need to reach this amount before the CGM coverage starts.
If under pharmacy benefits
Which pharmacies are in network?
Does it need to be via mail order?
Does it require a prior authorization and what is the process for this?
Can you provide information on any specific brands or models of CGMs that are preferred or covered under my plan?
Freestyle or Dexcom
Are there any limitations on the number of CGM supplies (sensors, transmitters, etc.) that are covered in a given time period?
Determine if there are limits on the quantity of CGM supplies you can receive. You’ll want this information for your health care provider when they are writing the prescription
Getting a prescription for the Freestyle Libre 2 CGM Supply Kit
Now that you know whether or not a CGM is covered under your plan and what is required, you’ll need to go to your health care provider and ask for a Libre 2 prescription. Most health care providers want their patients to be informed and comfortable in managing their blood sugars, so asking for a prescription will be no problem.
You can start the conversation by saying “I found out through my insurance that CGMs are covered. Would you be open to writing a prescription for me?” If you are having to get this through a durable medical equipment company, you can let the doctor know “the order form will be coming from Edgepark. Can you confirm your fax number?”
Also let them know specific insurance requirements for treatment, so they can include it in their office visit note which will be faxed to insurance.
“My plan requires that I am injecting insulin three times a day and checking my blood sugar four times a day. Could you make sure that is stated in the note? Insurance companies are so needy.”
Your health care provider is here for you and is on your side! Don’t ever feel ashamed about asking questions or making requests. You’re making THEIR life easier by knowing all that you found out through your insurance plan.
If your insurance company does not cover CGMs…
Unfortunately, some plans just suck. They may not cover CGMs for certain people with diabetes for a variety of reasons. If this is the case for you, you can do some research and price comparisons.
Here are some tips for comparing prices if you have to buy the Libre 2 sensor out of pocket:
1. Check Multiple Retailers: Start by checking prices at various retailers, both in-store and online. Common places to look include pharmacies, medical supply stores, and online marketplaces. Many of my clients have had great experiences paying out of pocket at Sam’s Club and Costco who offer lower cost Freestyle Libre 2 supplies.
2. Online Tools: Utilize online tools and websites that specialize in comparing prices for medical supplies. Websites like GoodRx or HealthWarehouse can help you find the best deals in your area.
3. Consider Online Pharmacies: Online pharmacies may offer competitive prices and the convenience of doorstep delivery. Make sure to choose reputable pharmacies and check for discounts or coupons.
4. Buy in Bulk: Often, buying Freestyle Libre 2 sensors in bulk can lead to cost savings. Check if there are discounts for purchasing multiple sensors at once.
5. Ask for Cash Discounts: If you're paying out of pocket, don't hesitate to ask for cash discounts at local pharmacies or medical supply stores. Some providers may offer reduced prices for cash payments.
6. Negotiate with Suppliers: In some cases, you may be able to negotiate prices with suppliers, especially if you're buying a significant quantity. Be polite but assertive when discussing pricing.
7. Use Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs): If you have an FSA or HSA, consider using these accounts to pay for Freestyle Libre 2 supplies. They offer tax advantages and can help reduce your out-of-pocket costs.
8. Keep Track of Expiration Dates: When purchasing sensors in bulk, be mindful of their expiration dates. Ensure that you'll use them before they expire to avoid wasting money.
9. Join Diabetes Support Groups: Online diabetes support groups and forums often share information about deals and discounts on diabetes supplies, including CGM sensors. Look for other's experience about finding Libre 2 sensors for sale. These communities can be a valuable resource for cost-saving tips.
10. Discuss with Your Healthcare Team: Consult your healthcare provider or diabetes care team for advice. They may have insights into where patients have found cost-effective options for Freestyle Libre 2 CGM Supply Kits in your area.
11. Be Mindful of Shipping Costs: If buying online, consider shipping costs. Sometimes, a slightly higher Libre 2 sensor price with free or low-cost shipping may be more economical than a lower Libre 2 sensor price with high shipping fees.
Remember that the cost of CGM sensors can vary significantly, so it's essential to invest time in research and price comparison to find the best deal for Freestyle Libre 2 sensors when paying out of pocket.
After receiving your Libre 2
Yay! It’s finally here. You really did get through the hardest parts, my friend. Let’s discuss next steps.
Set up for first time use
Setting up the Freestyle Libre 2 is a breeze – it's so user-friendly that many folks can tackle it just by watching a few short videos. Check out the startup guide at Abbott Diabetes Care by clicking here for a step-by-step walk through.
But hey, I get it, sometimes you crave that extra support. If that's the case, give your doc's office a call; they might have a diabetes care and education specialist who can lend a hand in person.
And guess what? I'm your go-to diabetes care and education specialist, and I'm here to make your life easier.
I offer my services entirely online, so you can rock your slippers while we sort things out. Ready to get started? Take a look here.
Observe trends
While you’re wearing a CGM for the first time, observe the trends your blood sugar goes through.
To identify these trends, regularly review your CGM data. Start by examining your glucose
levels throughout the day and look for patterns of highs and lows.
Note how your levels respond to meals, physical activity, and medication. Also, watch the glucose trend arrows. They indicate whether your blood glucose levels are rising, falling, or remaining constant.
You can monitor these patterns over time. This will help you make informed changes to your diabetes plan. It will improve your ability to keep your blood sugar levels stable. Ultimately, it will enhance your overall health.
Need help identifying trends?
Schedule a meeting with a diabetes specialist to review your CGM reports and develop a plan to reduce your A1c levels. Start here!