Effective October 1, 2025, Continuous Glucose Monitors (CGMs) will be covered with prior authorization (PA) for recipients (children and adults) with one of the following:
- type 1 diabetes mellitus
- type 2 diabetes mellitus or gestational diabetes AND are insulin treated with multiple (three or more) daily injections of insulin
The full criteria can be found here: Effective Oct. 1, 2025 - Continuous Glucose Monitor (CGM) Policy Checklist
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