CommercialCoverageHigh impact
Coverage change for continuous glucose monitors
Harvard Pilgrim Health Care·Endocrinology, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Tufts Health Direct is discontinuing coverage for Dexcom CGMs (G6 and G7) in favor of FreeStyle Libre as the preferred CGM product. Existing Dexcom users will be transitioned to FreeStyle Libre based on their usage duration, with phase-out dates of June 30, 2026 and December 31, 2026.
Action Required
By June 30, 2026: Identify all Tufts Health Direct patients currently using Dexcom CGMs and transition them to FreeStyle Libre prescriptions. Providers must write new prescriptions for FreeStyle Libre CGMs for affected patients. Update prior authorization processes to use fax 617-673-0988 for all CGM requests. For patients requiring continued Dexcom use, submit non-formulary exception requests through medical review process. Note that approved Dexcom exceptions must be filled at pharmacy, not DME supplier.