CGM Coverage with Saskatchewan Health
Does Saskatchewan provide Dexcom CGM coverage?
Yes, both Dexcom G6 and Dexcom G7 are eligible benefits under the Saskatchewan Drug Plan and are 100% funded by the province.
To receive coverage for Dexcom CGM under the Saskatchewan Drug Plan, you must meet the following requirements:
- Be between the ages of 18-25 years old and treat your diabetes with insulin, OR
- Be above the age of 65 and treat your diabetes with insulin, OR
- Be below the age of 18, and meet all of the following criteria:
- Be under the care and management of a pediatric endocrinologist, pediatric diabetes specialist, pediatric metabolic physician or certified diabetes educator within the Saskatchewan Health Authority who is working with a pediatric diabetes specialist, AND
- Individual and/or caregiver demonstrates the capacity to use CGM appropriately, AND
- Individual and/or caregiver demonstrates a reasonable understanding of what CGM can do and how it can benefit their care, AND
- Individual and/or caregiver affirms a willingness to use the CGM properly and to use the data from this technology to make safe and effective diabetes management decisions, AND
- Meet ONE of the following:
- Approved for the Saskatchewan Insulin Pump Program, OR
- On both basal AND bolus insulin, OR
- Have hyperinsulinism requiring frequent blood glucose monitoring.
For a complete description of provincial requirements, please visit: https://formulary.drugplan.ehealthsask.ca/Bulletins/Bulletin-0252-Mar-2025.pdf
Do I need a prescription to qualify for coverage?
Yes, to ensure you’re able to benefit from any private insurance you might have it is best to have a valid prescription. If you do not have a prescription, you can also ask your pharmacist for Dexcom CGM and they can help initiate the process for you.
What do I need to get coverage approval?
Residents of Saskatchewan who are either 18 to 25 years old or are over 65 years old and meet the eligibility criteria can bring their prescription for Dexcom CGM to their pharmacy. Your pharmacist will process your claim and check for insulin use. The pharmacist will bill the province for 100% of the cost and dispense your Dexcom CGM at no cost to you.
For children under the age of 18 who are on intensive insulin therapy and meet the eligibility requirements, you should contact your pediatric diabetes specialist to initiate the coverage assessment process on your child's behalf.
Requests initiated by approved designated prescribers within the diabetes care teams will need to add a notation on the prescription that your child meets the above criteria. You will be notified by your diabetes care team once your request has been processed, and a prescription has been sent to your designated pharmacy.
What if I have private insurance?
If you or your child is approved for coverage through Saskatchewan Health, you will be covered in full and your Dexcom CGM supplies will be billed directly to Saskatchewan Health by your pharmacy. If you are turning 26, we recommend you contact your insurance provider to inquire about coverage moving forward.
Where can I get my Dexcom CGM supplies?
You can purchase your Dexcom CGM supplies from your local pharmacy.
Will I have any out-of-pocket costs?
For those who are under 25 or over 65 years old and eligible for funding through Saskatchewan Health you will not have any out-of-pocket costs.
For those who only have private insurance, 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.
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 April 2025. Subject to change.
† Best available information as of April 2025. Subject to change.