CGM Coverage with the Non-Insured Health Benefits Program (NIHB)
Does NIHB provide Dexcom CGM coverage?
Yes, the NIHB has coverage for Dexcom CGM for eligible applicants. The Non-Insured Health Benefits (NIHB) program provides registered First Nations and recognized Inuit peoples with coverage for necessary health benefits including medical equipment such as Dexcom CGM.
Do I need a prescription to qualify for coverage?
All eligible NIHB clients managing their type 1 or type 2 diabetes with insulin qualify for coverage for Dexcom CGM in full under the program.
What do I need to get coverage approval?
With a prescription for Dexcom CGM from your doctor or nurse practitioner, your pharmacist will request coverage by contacting the NIHB Drug Exception Center (DEC) by phone at 1-800-580-0950, to check and confirm that you have claimed insulin on the NIHB plan before. If approved by the DEC, your pharmacist will be notified to set-up coverage for you at the pharmacy.
A Limited Use (LU) form may be required by the DEC if your claims history does not show the NIHB plan has paid for insulin claims on your behalf before.
How long am I approved for?
Coverage approvals are long-term.
Where can I get my Dexcom CGM supplies?
Once approved for coverage, your pharmacy will notify you and set up their systems to bill your Dexcom claims directly to NIHB. You may then order and pick up your Dexcom supplies in pharmacy or, if available, the pharmacy can ship the supplies to your location.
Will I have any out-of-pocket costs?
In some cases you may have out-of-pocket costs when purchasing at your pharmacy. If you find you do have a co-pay amount, 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.
Do you 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 June 14, 2024. Subject to change.
† Best available information as of June 14, 2024. Subject to change.