CGM Coverage with Alberta Health
Best available information as of July 26th, 2024. Subject to change. Not all group or individual plans with these insurers have adopted coverage.
Does Alberta Health† provide Dexcom CGM coverage?
Yes, Dexcom G6 coverage is available for eligible Albertans living with diabetes ages 2-18 who:
- Require ongoing use of insulin or an insulin pump when prescribed by a Specialist in Endocrinology or Pediatrics.
- Are enrolled in one of the following programs: Non-group coverage, Child and Family Services, Alberta Child Health Benefit, Children and Youth Services, Income support, Learners Program, Alberta Human Services (AISH), or the Alberta Adult Health Benefit.
Dexcom G7 is not an eligible benefit under Alberta Health programs currently.
Do I need a prescription to qualify for coverage?
Yes, you will need a valid prescription. You or your child will need to be evaluated by a Specialist in Endocrinology or Pediatrics to ensure you meet the program's medical criteria.
What if I have private Insurance?
Coverage through Alberta Health will not impact your private health plan coverage.
If you have a private insurance plan and would like to purchase Dexcom G7, return to step 1 of our guide to find details on your private plan’s coverage.
How long will I be approved for?
Once you receive a prescription from your specialist, coverage will continue until you or your child turns 18 or no longer meets 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 specialist, 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.
Secondary insurance plans may also work with your primary medical plan to help cover gaps in cost, services, or both. Check with your secondary insurer for details.
What if I need the optional receiver?
Dexcom G7 Receivers are available to order at pharmacy for those who would like to purchase Dexcom G7 through their private insurance.
What do I do if I have questions?
Our team is here to help! One of our 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 July 26th, 2024. Subject to change.
† Best available information as of July 26th, 2024. Subject to change.