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Expanded Coverage for Dexcom G7: More Private Insurers and Provincial Programs

Published on: 3 June 2024
Expanded Coverage illustration.

 

Dexcom G7 is our most accessible and affordable glucose sensor ever, covered by most private insurers and many provincial health programs, making it easier for individuals on insulin to proactively self-manage their diabetes.

Latest Coverage Expansions Include Beneva, Saskatchewan, and Nova Scotia

Dexcom G7 is increasingly covered through most private insurers in Canada and many provincial health programs. For the complete details and eligibility information, visit our coverage page.

In April 2024, Beneva, a private insurer in Quebec, and Saskatchewan Health Authority joined the list of those providing coverage for Dexcom G7. And most recently in June 2024, Nova Scotia announced new provincial CGM coverage that include both Dexcom G6 and Dexcom G7.

Beneva, which encompasses former insurers SSQ and La Capitale, has added Dexcom G7 as an eligible pay-direct pharmacy benefit for individuals currently using any basal or bolus insulin. Download our private insurance guide (PDF) for a detailed breakdown of private insurance coverage in Canada.

Saskatchewan Health Authority has added Dexcom G7 as a benefit for individuals under the age of 18 who are eligible under the provincial requirements, have a prescription, and an approved Exception Drug Status application.

 Nova Scotia has just announced new CGM coverage effective June 3, 2024, that includes both Dexcom G6 and Dexcom G7 as a benefit for eligible Nova Scotians with Type 1 and Type 2 diabetes using multiple daily injections of insulin (4 or more) or an insulin pump. Coverage is provided through the province’s existing Pharmacare programs, and the new income-tested Sensor-based Glucose Monitoring Program – whichever is better suited to an individual’s need and financial circumstance.

Complete details can be found on our coverage page.

Private Insurance Coverage for T1D and T2D on Insulin Therapy

With a prescription in-hand, most private insurers in Canada cover the Dexcom G7 rtCGM System for people living with T1D or T2D on insulin. 

The majority of private insurers cover Dexcom G7 as a ‘pay-direct pharmacy’ benefit through the pharmacy where the prescription is filled. This means the pharmacy can directly bill the insurer (up to the plan limits for the device) using a drug card, reducing the insured’s up-front out-of-pocket expenses.

Canada Life and Sun Life cover Dexcom G7 as a ‘pay & submit’ benefit. Insured clients need to pay upfront at the pharmacy, and submit their receipts to the insurer manually for reimbursement.

Complete details can be found on our coverage page, and you can also download our private insurance guide (PDF) for a detailed breakdown.

Patient Benefit Program Saves Dexcom G7 Users Up to 20% on Out-of-pocket Costs

The Dexcom G7 Patient Benefit Program covers up to 20% of Dexcom G7 copay costs, making it more affordable to more users, reducing or, in some cases, eliminating out-of-pocket costs entirely.

Participation is simple. All that is needed is a prescription for Dexcom G7 and a free program certificate (coupon), which the individual can download here or request a printed copy from their healthcare provider. The individual then presents the certificate at the pharmacy to be redeemed when the prescription is filled.

1 Beck RW, et al. JAMA. 2017;317(4):371-378.
2 Laffel L, et al. JAMA. 2020;323(23):2388-2396.
3 Welsh JB, et al. J Diabetes Sci Technol. 2022;18(1):143-147.
4 Martens T, et al. JAMA. 2021;325(22):2262-2272
5 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.

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