Dexcom and Abbott are awaiting a decision from the Centers for Medicare & Medicaid Services (CMS) on expanding coverage for continuous glucose monitoring (CGM) devices, a move that could make these devices available to a broad segment of people with diabetes in the United States. Under the current rules, Medicare coverage is limited to people with type 1 or type 2 diabetes who use insulin, or who have a history of concerning low blood sugar events.
The proposed expansion is expected to include people with type 2 diabetes who do not take insulin. Jake Leach, Dexcom's chief operating officer, told investors on an earnings call held in late July that the company expects to receive a response from CMS before the end of the year, with coverage taking effect in mid-2027. This does not represent a publicly announced final decision, but rather the company's timeline expectation regarding a regulatory process that is still pending.
A Potential Market of Millions of Beneficiaries
Dexcom estimates that about 25 million people in the United States have type 2 diabetes and do not use insulin. Leach said that about half of this group is of Medicare-eligible age, meaning the decision could significantly expand the potential user base for CGM devices. The chief operating officer described the move as one that could reshape diabetes care in the United States, a characterization that reflects the company's position rather than a settled regulatory outcome.
Abbott believes the potential change could make about 10 million additional Medicare beneficiaries eligible for monitoring devices and could also lead to broader coverage among commercial insurers. Robert Ford, the company's chief executive officer, said Abbott is preparing through sales, distribution and other resources to take advantage of the opportunity, which he estimated could represent a multibillion-dollar market, while acknowledging that he could not determine the timing of the decision precisely.
What Are the Companies Relying On?
Earlier in the summer, Dexcom presented results from a randomized controlled trial during the scientific sessions of the American Diabetes Association. The study lasted 26 weeks and found that participants who used a CGM device achieved a greater reduction in glycated hemoglobin A1C than the control group, and also spent an additional five hours per day within the normal glucose range. The company expects these results to support its request for expanded coverage, but the source does not state that CMS made a decision based on them or clarify the potential final coverage conditions.
Why Does This News Matter?
The potential change is not the launch of a new device, but rather a change in access to an existing technology through a broad government insurance program. If the expansion is approved, it would affect eligible patients, care providers and insurers, as well as Dexcom's and Abbott's distribution and sales chains. For now, the scale and timing of the impact depend on CMS's final decision and on eligibility and coverage details that were not announced in the material.
The companies' results also show that the expected expansion has a significant commercial dimension. Dexcom recorded sales of $1.31 billion in the second quarter, an annual increase of 13%, while Abbott's diabetes care sales reached $2.19 billion, an increase of 10.5%. These figures place the coverage expectations in the context of the companies' business growth, but they do not by themselves prove that the expansion will be approved or that market estimates will be achieved.