It might seem as if there aren’t that many options to claim CGM (Continuous Glucose Monitors) or flash glucose monitors (like the FreeStyle Libre) from your medical aid, but that’s simply not true. Here’s how to claim CGM from your medical aid.
Step 1: Find your medical aid in the lists below
Limited / no.
This is a current (March 2023) list of all the medical aids who currently support CGM in some form. If your medical aid isn’t on this list, please email SA Diabetes Advocacy and let’s change that! If your medical aid is on the list, take note of where: List 1, List 2 or Limited / no.
Step 2: Understand what they need in order to process / approve your claim
If your medical aid is on List 1:
CGM / flash glucose monitoring is offered as a Benefit for those with Type 1 diabetes. All you need is a script from your doctor to activate the Benefit.
If your medical aid is on List 2:
CGM / flash glucose monitoring is approved case-by-case for both Type 1 and Type 2 diabetes. Your doctor will need to write a script and motivate for why you need CGM / flash glucose monitoring (this does not need to be detailed – it can be that it is more advanced technology and offers better blood glucose control). This list includes all medical aids that have approved CGM / flash glucose monitoring in the past.
Depending on your medical aid and your option, there may be a co-pay.
If your medical aid is on the Limited / no list:
Most of these schemes still deny CGM / flash monitoring devices outright. But we still need to submit requests, so that they know there is pressure.
Step 3: Ask for help
If your medical aid rejects your request for a flash glucose monitor, you can complain to the CMS. Here’s exactly how to do that.
It may seem exhausting to have to jump through all these hoops to get this sensor technology, but it is well worth it for the life-changing effect of these devices. Let us know your experiences, and if you’ve had any luck claiming!
What to read next?
Everything you need to know about the FreeStyle Libre: We gathered all your questions and answered them – here’s all you need to know about the Libre.
What is a CGM? Flash glucose monitoring and CGM: Not sure what the difference is, or what these words mean? Read this article.
We did it! How to claim the Discovery CGM Benefit: A step-by-step guide to claiming the new CGM Benefit.