CGM Coverage in the Northwest Territories
Northwest Territories CGM coverage is managed by Alberta Blue Cross.
Does the Northwest Territories provide Dexcom CGM coverage?
Yes, Dexcom G6 and Dexcom G7 coverage is available for qualified individuals.
Government of Northwest Territories (GNWT) program members who meet the following criteria are eligible for real-time Continuous Glucose Monitoring (rtCGM) coverage:
- Children 19 years of age and younger on intensive insulin therapy (administration of short-acting insulin three or more times per day), or
- Clients with type 1 diabetes, as verified by short-acting insulin claims history.
Do I need a prescription to qualify for coverage?
Yes, you will need a valid prescription.
What do I need to get coverage approval?
For GNWT programs, rtCGM systems are limited-use benefits and require a prior approval request be submitted by the plan member’s physician to Alberta Blue Cross* for assessment based on the coverage criteria.
A prior approval request for CGM should be completed by the physician using the Exception Approval Drug Request form and be faxed to Alberta Blue Cross* at 1-877-828-4106.
How long am I approved for?
Coverage approvals are long-term until such time that you may no longer meet the eligibility criteria.
Where can I get my Dexcom CGM supplies?
You can pick up your Dexcom rtCGM supplies in the pharmacy, or the pharmacy may ship the supplies to your home.
Will I have any out-of-pocket costs?
Once approved for coverage, your pharmacy will be notified, and they will contact you. You will then be setup in the pharmacy system to have your Dexcom rtCGM claims directly billed.
For patients with deductible amounts, the Dexcom G7 Patient Benefit (Copay) program assists in reducing or eliminating out-of-pocket costs, saving patients up to 20%. Download a copy of the program certificate below, which can be redeemed at the 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.
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.