CGM Coverage with Alberta Health
Best available information as of December 16th, 2024. Subject to change.
Does Alberta Health† cover Dexcom CGM?
Yes, both Dexcom G6 and Dexcom G7 are covered for Albertans living with diabetes who are enrolled in a government-sponsored health benefit plan and meet one of the two following criteria:
- Under 18 years of age: require the ongoing use of any insulin OR insulin pump therapy.
- 18 years of age and older: require the ongoing use of insulin pump therapy, OR a basal and bolus insulin, OR a premixed insulin.
Do I need a prescription to qualify for coverage?
Yes, you will need a valid prescription for Dexcom G7 or Dexcom G6 from a physician, nurse practitioner, or pharmacist. You can then take your prescription to a local pharmacy to order your supplies, no further special authorization form or prior approval is required.
What if I have private Insurance?
Coverage through Alberta Health will not impact your private health plan coverage.
What is Non-Group Coverage and how do I apply?
All Albertans who want supplementary health insurance can apply for Alberta Blue Cross Non-Group Coverage. If approved for this coverage, you will be given an identification card and be billed a monthly premium as a member of the Non-Group Coverage plan through Alberta Blue Cross. This coverage will help reduce your out-of-pocket costs for Dexcom CGM.
How long will I be approved for?
Once you receive a prescription from your healthcare provider, coverage will continue until you or your child no longer meet the eligibility criteria.
Where can I get my Dexcom CGM supplies?
Dexcom CGM supplies can be ordered from your local pharmacy.
Will I have any out-of-pocket costs?
Once you receive a prescription from your healthcare provider, you may take it to your local pharmacy for it to be filled. Your pharmacist will submit your claim and, when needed, coordinate coverage between Alberta Health and your private insurance.
For any remaining out-of-pocket costs, the Dexcom G7 Patient Benefit Program assists in reducing or even eliminating up to 20% of out-of-pocket costs.* Download a copy of the program certificate below, which can be redeemed at your pharmacy with a valid Dexcom G7 prescription.
What if I need the optional receiver?
Government sponsored plans and private insurance plans cover the Dexcom G7 receiver in Alberta. Visit your local pharmacy to order a Dexcom G7 Receivers and have it billed to your insurance plan.
What do I do if I have questions?
Our team is here to help! One of our Reimbursement & Insurance Specialists can assist you in determining your coverage for Dexcom CGM. Get started by filling out our online form or call us at 1-844-832-1810.
*Based on reasonable upcharge, mark-up and customary pharmacy dispensing fee.
† Best available information as of December 16th, 2024. Subject to change.
† Best available information as of December 16th, 2024. Subject to change.