How to claim CGM from your medical aid

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.

As a reminder: Here’s the difference between CGM and flash glucose monitoring.

Step 1: Find your medical aid in the list below

This is a current (November 2022) 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 which column.

Step 2: Understand what they need in order to process / approve your claim

If your medical aid is on the Benefit list:

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.

Where it says <18, that means it’s specifically for children (those under 18). Where it says >18 or doesn’t mention a number, all ages are included.

If your medical aid is on the Benefit list, you can claim CGM / flash glucose monitoring. There may be a co-pay (either cash or from your savings) but the actual device does not come from your savings, it comes from the Benefit.

If your medical aid is on the Reimbursed list:

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).

Depending on your medical aid and your option, there may be a co-pay.

If your request for CGM / flash glucose monitoring was denied in the past, it’s worth submitting again. Medical aids are approving more and more requests for these devices, and the more people who request it, the more widespread it becomes.

Step 3: Ask for help

You don’t have to do this alone! If you’re applying for the FreeStyle Libre (the most affordable device), you can email or call 012 844 9000 and HealthWindow will help you through the motivation process.

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!

Step by step how to claim CGM from your medical aid

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.

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