Ontario to cover Dexcom G7 for insulin users: what you need to know

The Dexcom G7 is a real-time continuous glucose monitoring (rtCGM) system. It allows people living with diabetes to monitor their blood glucose levels around the clock without finger pricks. The system consists of two components:

1. Dexcom G7 Sensor (1-pack): Each sensor lasts for 10 days and includes a 12-hour grace period.
2. Dexcom G7 Receiver or mobile apps: Users can choose between a dedicated receiver device or apps available for both Android and iOS devices.

With these tools, users receive real-time updates on their glucose levels, helping them make informed decisions about food, activity, and insulin use. This not only supports better day-to-day management but may also reduce the risk of complications over time.

The Ontario Drug Benefit Program is a provincial plan that helps eligible Ontarians pay for prescription medications and medical devices listed in the Ontario Drug Benefit Formulary. The program primarily serves people who are:

• 65 years of age or older
• Living in long-term care homes or homes for special care
• Receiving professional home and community care services
• Receiving benefits from Ontario Works or the Ontario Disability Support Program (ODSP)
• Registered under the Trillium Drug Program

If you are part of any of these groups and are also living with diabetes and taking insulin, you are eligible to receive the Dexcom G7 system under this new coverage announcement.

To qualify for coverage under the ODB Program, you must meet the following criteria:

• Be a registered ODB recipient (see above)
• Be on insulin therapy for diabetes
• Have a valid prescription for the Dexcom G7 Sensor and/or Receiver from a physician or nurse practitioner

If you meet these conditions, you're eligible to receive the sensors and receiver at no cost, aside from any applicable co-payments as set out by the ODB regulations.

The Ministry of Health will reimburse pharmacies for the cost of Dexcom G7 sensors and receivers. The payment structure includes:

• The product price as listed in the provincial formulary
• An allowable mark-up
• A dispensing fee
• Minus any required co-payment or deductible

Each person can receive up to 45 Dexcom G7 sensors per year, which aligns with their 10-day lifespan plus grace period.

This change is significant. For many people managing diabetes with insulin, CGMs have been out of reach due to cost. By including Dexcom G7 in the ODB program, Ontario is making it easier for eligible residents to access this life-changing technology.

Real-time data can help users catch highs and lows before they become dangerous, adjust medication and food intake more accurately, and live more confidently with diabetes. It also reduces the burden of routine fingerstick testing.

Navigating government programs and medical technology can be complicated. That's where Endor Health comes in.

As a Canadian healthcare provider that specializes in diabetes support and device coordination, Endor Health helps patients and caregivers access the Dexcom G7 quickly and with confidence. If you'd like to order Dexcom G7 that is billed to ODB, you can:

• Add your prescriptions: it's easy to transfer your existing prescriptions from another pharmacy to the Endor App. It takes about 1 business day
• Order prescriptions direct billed and shipped free to your home: When you order Dexcom G7 and other prescription items from Endor Health, we'll direct bill ODB and/or other insurance plans as well as any available drug coupons to help get your cost down
• Device education and continued care: Access free help from Certified Diabetes Educators to help navigate life with your new device

Ontario's decision to fund Dexcom G7 CGM systems through the ODB Program is a big step forward for diabetes care. It means easier access, better tools for managing health, and fewer barriers for people who need real-time data to make life-saving decisions.

If you or a loved one qualifies for this new benefit, consider working with Endor Health to make the process smooth and supportive. Better diabetes care starts with the right tools — and now, they're finally within reach for more Canadians.