On June 2, 2023 Senseonics announced that UnitedHealthcare, the biggest medical insurance company in the US, will start covering their Eversense E3 implantable CGM systems starting July 1, 2023 for individuals with type 1 diabetes (T1D) and insulin-requiring type 2 diabetes (T2D). That is great news for individuals who depend on continuous glucose monitors (CGM) to trace their blood sugar levels.
What’s the Eversense E3 system?
The Eversense E3 CGM system is the one long-term, implantable CGM system available in the US. It was first approved by the Food and Drug Administration (FDA) in 2022 to repeatedly measure blood sugar levels for six months in people 18 years and older.
It’s approved as a therapeutic CGM, replacing fingerstick blood sugar measurements to make medication and treatment decisions.
The system features a small sensor inserted under the skin that communicates with a transmitter worn over the sensor. Blood sugar readings are robotically sent every five minutes to a mobile app on the user’s smartphone.
Unlike other CGM systems available on the market, the Eversense insertion and removal procedures require an in-office visit and are performed by trained and licensed medical providers. This coverage expansion will include payment for the insertion of the device.
The advantages of a CGM
Unlike manually checking your blood sugar levels multiple times per day, a CGM allows the user to trace their blood sugars on a trend line, helping to higher predict each high and low blood sugar levels before they occur.
CGMs may give people peace of mind and make managing diabetes easier. Moreover, CGM use is related to lower blood sugar and A1C levels, even in individuals with type 2 diabetes not using mealtime insulin.
Getting access to a CGM is a health equity necessity, and this variation will profit individuals with diabetes in impactful ways.
What is going to coverage seem like?
UnitedHealthcare’s expansion will bring more selection to individuals with diabetes who use technology to assist manage their blood sugar levels.
Tim Goodnow, PhD, president and chief executive officer for Senseonics agrees, saying, “The policy update from UnitedHealthcare marks a very important milestone for increased access to long-term CGM for individuals with diabetes. With the addition of UnitedHealthcare, we’re nearing all insured adults in the US getting access to the Eversense E3 CGM System.”
This alteration will make the Eversense CGM system available to over 300 million insured Americans.
What this implies for individuals with diabetes
This can be a huge expansion of coverage for the Eversense system, adding about 45 million more people under its coverage. Diabetes technology like CGMs are still hard for many individuals to access in the US, especially for individuals with T2D.
Even when people have access to medical insurance, oftentimes insurance providers have many eligibility requirements, akin to multiple day by day injections (MDI) for individuals with T2D.
This alteration will allow access for a lot of more individuals with each type 1 and kind 2 diabetes who use any amount of insulin in a day, to utilize this lifesaving technology—many for the primary time ever.
When you are fascinated about trying the Eversense E3 CGM system, seek advice from your doctor now to start out getting any obligatory documents ready, like prior authorizations.
People who find themselves fascinated about learning more can enroll with Eversense here. Healthcare providers who’re fascinated about offering the Eversense CGM system can enroll here.
You too can call 844-SENSE4U (844-736-7348) to learn more.