Cost of CGM Must be Covered in Illinois, Pursuant to June 15th Legislation

Continuous glucose monitors (CGM) must now be covered by insurance plans for persons with type 1 (T1D) and type 2 diabetes (T2D) in the state of Illinois, according to a press statement from the office of Illinois Governor JB Pritzker.

On June 15, 2022, Pritzker signed legislation into law that requires group and individual health plans and managed care plans to cover the cost of “medically necessary continuous glucose monitors for individuals who are diagnosed with type 1 or type 2 diabetes and require insulin for the management of their diabetes,” according to the Illinois General Assembly’s website.

"No one—regardless of their socioeconomic status or insurance coverage—should go without the care they require," said Pritzker in the statement. "That is an unacceptable burden to ask diabetics [sic] to bear, and this legislation will ensure insurance companies support these essential devices and those that use them" 

Pritzker signed the bill at Lurie Children’s Hospital of Chicago last week and it is slated to go into effect January 1, 2024. At that point, any insurance plan which is amended, delivered, issued, or renewed must include the coverage, according to the General Assembly. The bill passed both the state senate and house with unanimous approval.

“While Illinois has capped the cost of insulin, it is only right that we include and make more affordable life-changing devices that improve a person’s quality of life,” said Rep. Suzanne Ness (D-Crystal Lake). “And Senate Bill 2969 does just that.”

Diabetes disproportionately affects minority and low-income communities, exacerbating the gap in health equity caused by the expensive CGM devices. Data from the Centers for Disease Control and Prevention shows that Black, Hispanic, and Native Americans in Illinois and throughout the US, are at higher risk for diabetes. The legislation, according to the governor’s statement, ensures that Illinois residents at the greatest risk won’t be denied insurance coverage essential for maintaining health and avoiding medical emergencies. Persons with diabetes whose blood glucose fluctuates above or below recommended levels risk chronic and sometimes fatal complications which also drive up health care costs.

"This is a development in science that should be available to help people better regulate their diabetes," said State Senator Julie Morrison (D-Lake Forest). "Glucose monitoring systems should be covered the same as other medical equipment. Today we are taking a positive toward making these devices more accessible."

The American Diabetes Association (ADA) also lauded the new law and noted it will lower the risk for dangerous complications of diabetes.

“Advances in diabetes technology are changing lives,” said Gary Dougherty, the director of state government affairs for the ADA. “Continuous glucose monitoring provides glucose readings every few minutes, allowing for improved monitoring and management of diabetes.”

“Seeing this signed into law is an important and necessary step to providing real public safety for every community and making sure that they have the healthcare that they need during times of serious crisis, pain, and fear,” said State Senator Robert Peters (D-Chicago).