There are two aspects of the Eversense E3 cost:
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1. The Eversense E3 product
Price of the product will vary depending on your type of insurance. -
2. Sensor Insertion and Removal*
Price is set by your Health Care Provider and will also vary depending on insurance.
Depending on your insurance coverage, you may receive one bill for both or two separate bills.
Looking to save?
How can you pay for Eversense?
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Commercial Insurance
300+ million people have insurance that covers the Eversense E3 CGM System. If you're on insulin you might benefit from Eversense E3.
Through the Eversense PASS™ (Payment Assistance and Simple Savings) program, you may be eligible for a $99 offer** for your sensor and transmitter and subsequent sensors.*
Click here to learn about the program.
You can also pay with pre-tax dollars from your FSA or HSA.
Offers do not apply to the insertion or removal procedure.*Have more questions? Click here to see frequently asked questions.More InformationMost private payers cover CGM for specific patient populations, often based on the type of diabetes, treatment and level of control. Most major commercial health plans have written policies that offer explicit guidelines for coverage.
Coverage varies by plan or group within each insurance company, and it's important to understand the specific coverage criteria for your case. We can help to determine if your plan covers Eversense. Click here and we will look into this for you.
There are three potential options for how each insurance company will process the claimBundled code (Global Payment Model): (1 claim process)In this option, the product and the procedure will be treated as one claim. This can help to streamline the process.
The health care professional orders the device from one of our preferred partners and submits the claim to the insurance company, you pay the HCP co-pay/co-insurance when the HCP implants the device.
Pharmacy Benefit: (2-claim process)In this option, the product and the procedure will be treated separately, as 2 different claims.
The Eversense CGM System will be processed and distributed by an in-network Specialty Pharmacy utilizing your pharmacy benefit. You will receive a call from a preferred partner to discuss any required co-pays. The pharmacy will ship the Eversense CGM System directly to the HCP inserting the Eversense Sensor. The HCP and the pharmacy will each submit claims and collect any required co-pay from you.
Durable Medical Equipment (DME) Benefit: (2-claim process)In this option, the product and the procedure will be treated separately, as 2 different claims.
The DME supplier is determined by your insurance company. You will receive a call from the DME supplier to discuss coverage and any potential co-pay. The supplier will ship the Eversense CGM System directly to the HCP inserting the Eversense Sensor. The DME and HCP will each submit claims and collect any required co-pay from you.
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Medicare
The Eversense E3 CGM System is covered by Medicare for insulin dependent patients who meet the Medicare coverage criteria. If you're on insulin you might benefit from Eversense.
Click here to learn more and see if you're eligible for Eversense under Medicare.
Have more questions? Click here to see frequently asked questions.
*The sensor is inserted/removed by a trained health care provider in the upper arm
** Offer does not apply to the insertion and removal procedures. The Eversense PASS Program has limitations on eligibility. See website (bit.ly/EversensePass) for more details. Ascensia Diabetes Care reserves the right to change or terminate this program at any time without notice. The program benefit is capped per transaction. There may be instances in which out-of-pocket costs exceed what is detailed in the offer.
