On June 2, 2023 Senseonics announced that UnitedHealthcare, the largest health insurance company in the United States, will start covering their Eversense E3 implantable CGM systems starting July 1, 2023 for people with type 1 diabetes (T1D) and insulin-requiring type 2 diabetes (T2D). This is great news for people who rely on continuous glucose monitors (CGM) to track their blood sugar levels.
What is the Eversense E3 system?
The Eversense E3 CGM system is the only long-term, implantable CGM system available in the United States. It was first approved by the Food and Drug Administration (FDA) in 2022 to continually measure blood sugar levels for six months in people 18 years and older.
It is approved as a therapeutic CGM, replacing fingerstick blood sugar measurements to make medication and treatment decisions.
The system includes a small sensor inserted under the skin that communicates with a transmitter worn over the sensor. Blood sugar readings are automatically sent every five minutes to a mobile app on the user’s smartphone.
Unlike other CGM systems on the market, the Eversense insertion and removal procedures require an in-office visit and are performed by trained and certified medical providers. This coverage expansion will include payment for the insertion of the device.
The benefits of a CGM
Unlike manually checking your blood sugar levels multiple times per day, a CGM allows the user to track their blood sugars on a trend line, helping to better predict both high and low blood sugar levels before they occur.
CGMs can give people peace of mind and make managing diabetes easier. Additionally, CGM use is associated with lower blood sugar and A1C levels, even in people with type 2 diabetes not using mealtime insulin.
Having access to a CGM is a health equity necessity, and this change will benefit people with diabetes in impactful ways.
What will coverage look like?
UnitedHealthcare’s expansion will bring more choice to people with diabetes who use technology to help manage their blood sugar levels.
Tim Goodnow, PhD, president and chief executive officer for Senseonics agrees, saying, “The policy update from UnitedHealthcare marks an important milestone for increased access to long-term CGM for people with diabetes. With the addition of UnitedHealthcare, we are nearing all insured adults in the United States having access to the Eversense E3 CGM System.”
This change will make the Eversense CGM system available to over 300 million insured Americans.
What this means for people with diabetes
This is 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 people to access in the United States, especially for people with T2D.
Even when people have access to health insurance, oftentimes insurance providers have many eligibility requirements, such as multiple daily injections (MDI) for people with T2D.
This change will allow access for many more people with both type 1 and type 2 diabetes who use any amount of insulin in a day, to utilize this lifesaving technology—many for the first time ever.
If you are interested in trying the Eversense E3 CGM system, talk to your doctor now to start getting any necessary documents ready, like prior authorizations.
You can also call 844-SENSE4U (844-736-7348) to learn more.