CGM coverage in Quebec

Saskatchewan provides coverage for continuous glucose monitoring systems (CGMs) and flash glucose monitoring systems through the Saskatchewan Drug Plan. These systems are referred to as Advanced Glucose Monitors. Coverage is available for eligible residents living with diabetes who meet the program requirements. Effective April 1, 2025, Saskatchewan expanded coverage to include young adults aged 18 to 25 and seniors aged 65 and older who use insulin. This expansion builds on pediatric coverage that has been in place since 2021.

To learn more about which CGM systems are available across Canada, visit Our Guide to Continuous Glucose Monitors in Canada.

RAMQ provides CGM coverage for Quebec residents with diabetes who meet age-specific and clinical eligibility requirements.

For children and youth ages 2 to 17 years: You must have Type 1 diabetes. 

For adults 18 years of age and older: You must have Type 1 or Type 2 diabetes and be treated with intensive insulin therapy.

Intensive insulin therapy is defined as: 

• Treatment with an insulin pump, 
• OR three or more insulin injections per day

In addition to being on intensive insulin therapy, you must meet at least one of the following clinical criteria: 

• Failure to achieve your target glycated hemoglobin (HbA1c) value despite optimal disease management and regular blood glucose testing
• Frequent episodes of hypoglycemia during the past year despite following a blood glucose management plan, OR Inability to recognize or report symptoms of hypoglycemia 
• You must also be a Quebec resident enrolled in the RAMQ Public Prescription Drug Insurance Plan

RAMQ covers continuous glucose monitoring systems that provide real-time glucose readings and flash glucose monitoring systems. 

Currently approved systems include:

• Dexcom G6
• Dexcom G7
• FreeStyle Libre 2 

These devices meet Health Canada safety standards and are appropriate for people with diabetes who use insulin therapy. Medtronic Guardian sensors are not currently listed in RAMQ's public coverage but may be available through private insurance plans.

What RAMQ funds:

• CGM sensors according to your approved treatment plan
• CGM transmitters and readers as required for your prescribed system

What RAMQ does not cover: 

• Lost or stolen devices
• Adhesive products or skin barrier wipes
• Smartphones or mobile devices of any kind

👉 For the most current information about covered devices and eligibility criteria, visit the RAMQ website or contact RAMQ at 1-800-561-9749.

The application process requires a prescription from your healthcare provider and completion of an Exceptional Medication Form. 

Step 1: Speak with your healthcare provider

Tell your physician or pharmacist that you would like to receive a prescription for a CGM system. Your healthcare provider will assess whether you meet the eligibility criteria for RAMQ coverage. 

Step 2: Complete the Exceptional Medication Form 

Your physician or pharmacist will complete an Exceptional Medication Form and submit it to RAMQ for approval. This form documents that you meet the clinical eligibility requirements for CGM coverage. 

Step 3: Wait for approval RAMQ will review your application

Initial approval is typically granted for a six-month period to determine if CGM is suitable for your diabetes management. 

Step 4: Purchase your CGM at a pharmacy

Once approved, you can purchase your CGM sensors and supplies at your local pharmacy. Your pharmacist will process your claim through RAMQ according to the Public Prescription Drug Insurance Plan.

After the initial six-month period, your physician will need to reassess your condition annually to confirm you continue to meet the eligibility criteria. You must follow up with your healthcare provider before your coverage period ends to ensure uninterrupted access to CGM supplies.

You are generally eligible for the Public Prescription Drug Insurance Plan if you: 

• Are a Quebec resident without access to a private insurance plan through an employer or family member 
• Are under 18 years of age and your parents do not have access to a private plan 
• Are receiving last-resort financial assistance or certain other government benefits

When you purchase CGM sensors covered under the public plan, you pay a portion of the cost: 

• A monthly deductible (amount varies by year)
• A percentage of the co-insurance after reaching your deductible
• Up to your maximum annual contribution 

The reader for FreeStyle Libre systems is provided free of charge by your pharmacist, as the manufacturer provides them at no cost. You should never be charged for a reader at your pharmacy.

If you do not meet RAMQ eligibility criteria, there are other ways to access CGM technology. 

Private insurance: All private insurance plans in Quebec must provide coverage that is at least equivalent to RAMQ criteria. Most private insurance plans offer broader coverage for CGM systems, including coverage for anyone with diabetes who uses insulin, and some plans cover anyone with diabetes regardless of treatment. Check with your insurance provider for specific coverage details. 

‍Out-of-pocket costs: You can purchase CGM systems directly without insurance. Costs vary by device and usually include the transmitter and reader if needed, plus ongoing sensor costs that generally range from $250 to $400 per month.

Managing your supplies and staying connected with your diabetes care team is important for safe and effective CGM use. The Endor Health app supports ongoing communication with your care team so questions about your CGM data or therapy can be addressed promptly. The app also provides convenient home delivery of insulin, prescription items, and CGM sensors at no added cost, helping reduce the risk of missed refills or last minute pharmacy visits.

The information in this article is for educational purposes only and should not replace advice from your healthcare provider. Always consult with your diabetes care team before making changes to your diabetes management.