Why 1 in 5 Diabetes Patients Skip CGMs — and How OTC CGM Costs Drive That Decision
Over-the-counter continuous glucose monitors promised to make blood sugar tracking easier for millions of people, but the price tag rarely ends at checkout. The hidden costs of OTC CGMs are tucked inside subscription plans, replacement sensors and app access — and for many users, those recurring charges add up faster than the starter kit suggests. Understanding what you are actually buying before you click “order” can save hundreds of dollars a year.
These devices are not single-purchase gadgets like a smartwatch. They are recurring systems built around consumable hardware and software access, which means the real cost lives in what comes after the first box arrives.
For more information: Choosing Between Stelo, Lingo and Levels for Diabetes: Everything to Know About OTC CGMs
How the CGM Subscription Model Really Works
Unlike a fitness tracker you buy once and use for years, a CGM is built around disposable sensors that stop functioning after a fixed wear period — typically a few days up to about two weeks, depending on the system. Each sensor cannot be reused or recharged. When it expires, you replace it, and the meter on your monthly spending starts again. That structure is what turns an over-the-counter glucose monitor from a one-time purchase into an ongoing subscription.
According to Forbes, starter kits usually range from $49 to $99, while ongoing subscriptions can run from $89 to $250 depending on brand and duration. Quality can also vary between systems.
OTC options are also more limited than prescription versions. Per GoodRx, OTC CGMs are only FDA cleared for adults 18 and older, while prescription models like the Dexcom G7 can be cleared for children as young as 2. Reading frequency differs too — Stelo takes a reading every 15 minutes, while Lingo and many prescription CGMs read as often as every minute. Stelo, in particular, currently offers a three-month subscription for $252.
Sensor Fees, App Access and What You Don’t Get With OTC
The sensor is the biggest recurring expense, but it is not the only one. OTC CGMs are sold directly through manufacturer websites — you won’t find them in community pharmacies — and the experience is tied to the brand’s app. That bundle of hardware and software is where the fees stack up, and it is also where OTC versions fall short of prescription alternatives.
GoodRx points out several features OTC users do not get. OTC CGMs do not provide alerts for out-of-range glucose levels — only prescription models offer that. Stelo isn’t cleared for people prescribed insulin, so it isn’t compatible with smart insulin pens, insulin pumps or automated insulin delivery systems. For someone managing diabetes, those limitations matter as much as the price.
How Much Money Insurance Actually Saves You
For people with diabetes, insurance can change the math dramatically — but only if you qualify and only if you navigate the paperwork. According to the National Endocrinology Specialists, the annual cost of continuous glucose monitors in 2025 ranged from $2,000 to $4,500 without insurance, though coverage and assistance programs lowered that figure significantly.
Most insurance plans require prior authorization and documentation from a healthcare provider, after which out-of-pocket costs are often reduced to a manageable copay. Medicare has expanded CGM coverage in recent years: since 2023, beneficiaries who use insulin or have a history of hypoglycemia have been eligible, and in 2025 Medicare covered 80% of the approved CGM cost, leaving patients responsible for 20% after meeting their Part B deductible. For many, that reduced annual spending to around $600 to $1,200, compared with the thousands paid without coverage.
Medicaid coverage is state-dependent. Some states provide CGMs with no cost-sharing, while others limit eligibility to Type 1 diabetes patients or require strict documentation. Patients should check their state’s Medicaid policy before purchasing.
Who Is Skipping CGMs Because of the Cost
The financial pressure is showing up in patient behavior. According to an American Diabetes Association survey of 2,595 people with diabetes, one in 5 said they had foregone or put off getting a pump or continuous glucose monitor. For half of them, the reason was financial strain. Another 15% who rely on pumps or CGMs said they had delayed refilling supplies during the pandemic, with 70% citing cost as the driver.
Earlier ADA data found that about 31% of diabetes patients reported not self-monitoring glucose levels because test strips were too expensive, and 47% said testing was not convenient. A 2021 study framed the issue more broadly, noting that “cost considerations for diabetes technology uptake extended beyond finances to include time, cost to society, morality and interpersonal relationships.”
Some patients still choose fingersticks over a CGM. According to Edgepark, fingersticks can be easier to restock away from home, may be more affordable than CGM and provide in-the-moment data.
Ways to Cut the Cost Without Giving Up CGM
Because CGMs are an ongoing expense, users have found ways to trim the bill. The National Endocrinology Specialists suggest practical steps like comparing pharmacy prices, seeking insurance prior authorization and using manufacturer programs to significantly reduce out-of-pocket costs.
Some patients save by buying CGM supplies through online mail-order pharmacies, which often offer discounts for automatic refills. Others use employer wellness programs that reimburse part of the cost. For people without insurance, talking with a doctor can open the door to samples, coupons or nonprofit support that take some of the sting out of the recurring sensor fees.
This article was created by content specialists using various tools, including AI.
