Understanding healthcare costs can be challenging, as there are many variables that can impact them. We can help you navigate this.
200 million people have insurance that covers the Eversense 90-Day System. If you're on insulin you might benefit from Eversense.
If you can't afford your co-pay or if Eversense is not covered, you might be eligible for the Patient Assistance Program, that can offer savings of up to $300 dollars per sensor and transmitter per year††. Click here to learn about the program.
You can also pay with pre-tax dollars from your FSA or HSA.
Most private payers cover CGM for specific patient populations, often based on the type of diabetes, treatment and level of control. Most major commercial health plans have written policies that offer explicit guidelines for coverage.
Coverage varies by plan or group within each insurance company, and it's important to understand the specific coverage criteria for your case. We can help to determine if your plan covers Eversense. Click here and we will look into this for you.
In this option, the product and the procedure will be treated as one claim. This can help to streamline the process.
The HCP orders the device from one of our preferred partners and submits the claim to the insurance company, you pay the HCP co-pay/co-insurance when the HCP implants the device.
In this option, the product and the procedure will be treated separately, as 2 different claims.
The Eversense System will be processed and distributed by an in-network Specialty Pharmacy utilizing your pharmacy benefit. You will receive a call from a preferred partner to discuss any required co-pays. The pharmacy will ship the Eversense System directly to the HCP inserting the Eversense Sensor. The HCP and the pharmacy will each submit claims and collect any required co-pay from you.
In this option, the product and the procedure will be treated separately, as 2 different claims.
The DME supplier is determined by your insurance company. You will receive a call from the DME supplier to discuss coverage and any potential co-pay. The supplier will ship the Eversense System directly to the HCP inserting the Eversense Sensor. The DME and HCP will each submit claims and collect any required co-pay from you.
The Eversense 90-Day System is covered by Medicare for insulin dependent patients who meet the Medicare coverage criteria. If you're on insulin you might benefit from Eversense.
Eligible Medicare users may pay as little as zero dollars out of pocket.*
Click here to learn more and see if you're eligible for Eversense under Medicare.
You can still benefit from Eversense even if you don't have insurance. Our Patient Assistance Program may be able to help reduce out of pocket cost. Click here to learn more about it.
Credit institutions like Care Credit could be another option to help you pay for medical expenses not covered by insurance
*The sensor is inserted/removed by a trained health care provider in the upper arm