Getting a Continuous Glucose Monitor CGM?
This page was last updated: 22 December 2023
Continuous Glucose Monitor CGMs are available on the HSE’s Long-Term Illness Scheme. However, there are restrictions on eligibility (see Are you eligible section below).
They can also be purchased online or through your local chemist, but can be expensive. Some of the companies offer free trials of their CGMs before buying if you are unsure if a CGM is for you. If you are self-funding your sensors, there are tax refunds you can claim, see the section below on how to claim tax refunds for more details.
There is a link in the button below to the list of all Flash and CGMs available in Ireland, detailing some of their features as well as contact details for the companies providing them.
Are you eligible for a HSE-funded CGM?
There have been several changes in the Eligibility Criteria for CGMs since the publication of HIQA’s Rapid HTA in September 2023. Most of these changes became effective on the 1st of December, 2023. However, it is still unclear (at the time of writing) if there is now a separate criteria for the Freestyle Libre 1 and all other CGMs, including the Freestyle Libre 2.
Eligibility Criteria for ALL
You must have Type 1 Diabetes to be eligible for a HSE-funded CGM; however, there are different additional criteria which may still apply (we are awaiting an update from the HSE on this) that depend on if you are aged over or less than 18 years old.
* Reimbursement of CGMs has not been extended to any other types of diabetes at the present time.
Eligibility Criteria for Freestyle Libre 1 (or Flash) for ALL ages
As mentioned above, it is unclear if these separate criteria for the Freestyle Libre 1 still apply, but just in case they do, here is the updated list.
Type 1 Diabetes
The criteria of being aged 4 - 21 years was removed as of the 1st of December 2023.
Using multiple daily injections of insulin or insulin pump therapy
Have increased blood glucose testing requirements greater than or equal to 8 times daily
Frequent episodes of diabetic ketoacidosis (DKA) or hypoglycaemia, which have included hospital admissions
If you are seeking a HSE-funded CGM that is not the Freestyle Libre 1, please see the following sections on eligibility, as there are different additional criteria which may still apply if you are aged over or less than 18 years old.
Eligibility Criteria for All other CGMs
All other CGMs include Dexcom G6 and G7, GlucoRx Aidex, Freestyle Libre2 and Medtronic Guardian systems (G3, G4 and Glucose Enlite).
CGM Eligibility Criteria for Children and Young People under 18 years
The eligibility criteria for Continuous Glucose Monitors CGMs for Children and Young People aged under 18 years are listed in the HSE’s National Clinical Guideline for Managing Children with Type 1 Diabetes who use Continuous Glucose Monitoring or Flash Glucose Monitoring, page five in Section 8.2 Patient Eligibility Criteria.
8.2.2 Continuous Glucose Monitoring (CGM) with alarm functionality is indicated for children with T1DM who:
Are unable to recognise or communicate hypoglycaemia symptoms or have hypoglycaemia unawareness with adverse consequences
Are unable to optimise control despite good self-management skills, including capillary glucose monitoring greater than 4 times per day.
CGM Eligibility Criteria for People over 18 years with Type 1 Diabetes
Unfortunately, if you are an adult who does not have type 1 diabetes, you are not eligible for a HSE-funded CGM. Hopefully, this will be amended soon, and people with other types of diabetes will be eligible.
If you are seeking a HSE-funded Freestyle Libre 1, please see the section above on “Eligibility Criteria for Freestyle Libre 1 (or Flash) for ALL ages”.
For all other CGMs (Dexcom G6 and G7, GlucoRx Aidex, Freestyle Libre2 and Medtronic Guardian systems: G3, G4 and Glucose Enlite), the eligibility criteria for people aged 18 years and older are listed in the National Clinical Guidelines for Adults with Type 1 Diabetes, on page 27-28, under Section 3.6.22. However, these guidelines are in the process of being updated by the National Clinical Programme for Diabetes Working Group and will be posted here when published.
3.6.22 Consider real-time continuous glucose monitoring for adults with type 1 diabetes who are:
Willing to commit to using it at least 70% of the time and to calibrate it as needed, and
who have any of the following despite optimised use of insulin therapy and conventional blood glucose monitoring:
More than 1 episode a year of severe hypoglycaemia with no obviously preventable precipitating cause.
Complete loss of awareness of hypoglycaemia.
Frequent (more than 2 episodes a week) asymptomatic hypoglycaemia that is causing problems with daily activities.
Extreme fear of hypoglycaemia.
Hyperglycaemia (HbA1c level of 75 mmol/litre [9%] or higher) that persists despite testing at least 10 times a day (see recommendations 3.6.11 and 3.6.12).
Continue real-time continuous glucose monitoring only if HbA1c can be sustained at or below 53 mmol/mol (7%) and/or there has been a fall in HbA1c of 27 mmol/mol (2.5%) or more.
Now that you know if you are eligible, how do you go about applying for a HSE-funded CGM?
How do I apply for a HSE-funded CGM?
There have been a number of changes to how the application system works - all in since December 1, 2023. There is now a single reimbursement application system for all CGMs.
Before this, there were several systems in use: one for Freestyle Libre 1, one for a CGM requiring a separate transmitter and none at all for a CGM that didn’t require a separate transmitter that wasn’t a Libre. It is now the same process for all CGMs, which have been condensed into two steps below.
Step 1. Talk to your Diabetes Team
From the 1st of December 2023, the only individual(s) who can now submit an application for ALL CGMs is your diabetes consultant or team.
The applications are reviewed by the HSE Medicines Management Programme (MMP) and possibly approved by them.
I assume once an individual is approved, they will receive notification from their team, and a transmitter, if required, will be sent to your diabetes clinic or to your home.
It is unclear if this separate transmitter will also have to be approved by the local HSE Community Funded Schemes department still or if the HSE MMP will now deal with this also.
Step 2. Prescription for Sensors
Once your diabetes team have issued you with a prescription for your sensors, you can take it to your chemist to get your sensors.
The chemist will need to confirm approval through the online Secure Schemes Checker under ‘Patient Specific Arrangements’ from 1 December 2023.
And Happy CGM-ing!
Information for those self-funding
Continuous Glucose Monitor CGMs can be bought online through each company’s website or through your local chemist, but they can be expensive.
Some of the companies offer free trials of their CGMs before buying if you are unsure if a CGM is for you. Here is a link to the list of Flash and CGMs that are available in Ireland, detailing some of their features as well as contact details for the companies providing them.
If you do end up self-funding your CGM, there are tax refunds you can claim, such as a VAT refund, AND you can claim an income tax refund on the remaining cost as part of your Health Expenses when you fill out your annual Income Tax Return.
Claim a VAT Refund
The VAT refund is 23% of the cost, and you will need to have copies of your receipts as proof of purchase.
This link explains how to Apply for a refund of Value-Added Tax (VAT). This claim is specifically for people with disabilities; however, diabetes is legally recognised as a disability in order to be included on the Long-Term Illness scheme.
Claim an Income Tax Refund
You can also claim income tax relief on the cost of all your health expenses when you are completing your end-of-year tax return. You generally receive tax relief for health expenses at a standard rate of tax (20%). This link will take you to the Revenue page on How do you Claim health expenses. This used to be done through the old MED1 Form.