General information, not medical advice or an insurance coverage decision. MedraxDME operates as an out of network supplier. Coverage, supplier enrollment requirements and patient responsibility depend on the plan and an individual review.
What Florida’s CGM statute addresses
Florida Statute 409.9063 describes a Medicaid pharmacy benefit for eligible people diagnosed with diabetes who have prescriptions for insulin and a CGM. The law also addresses ongoing clinical follow up and necessary repairs or replacement parts. Its funding and program conditions still apply; reading the statute is not an individual authorization.
Use the law as a starting point for a conversation with the prescribing office. Ask which current plan or pharmacy policy applies to you, whether a prior authorization or claim review is needed, and which pharmacy can dispense the prescribed product. Those operational details determine how the request moves forward.
Use the current preferred product list
AHCA’s preferred product list effective October 1, 2026 includes Dexcom and Abbott CGM components and assigns different limits to sensors, receivers and separate transmitters. Sensor quantities depend on the product and labeled duration. A receiver allowance is not the same as a recurring sensor allowance.
Ask the pharmacist to identify the exact product number and the number of devices in the prescribed package. Do not assume that a newer sensor, an older reader and a familiar mobile app form a compatible system. If the prescription changes, ask your clinical team to review the full setup before any substitution is made.
Ask the pharmacy to identify the actual obstacle
The AHCA pharmacy policy resource page brings together current product lists, prior authorization information and diabetic supply guidance. Have the pharmacy identify whether the request needs a clinical review, a different billing product, a timing correction, or confirmation of another insurance benefit.
- Which exact item did the pharmacy attempt to process?
- Was the result a request for more information or a final denial?
- Who must supply the missing information?
- Can the pharmacy provide the response for your prescribing office?
- What should happen next, and who will contact you?
This approach is more useful than submitting the same request to several pharmacies without knowing why it failed.
Keep follow up appointments connected to the request
The Florida statute specifies follow up at least every six months during the first 18 months after the initial CGM prescription, then at least every 12 months. Your treating professional may recommend more frequent clinical contact. Review the statutory follow up provision with the office handling the prescription.
Ask the office to tell you when the next benefits related visit or prescription renewal should be scheduled. Keep that administrative reminder separate from the dates your clinician sets for medical care. If an appointment changes, let the dispensing pharmacy know early so it can explain whether the pending supply request needs updated records.
Avoid confusion between devices and replacement requests
Before requesting a refill, check the name on the current sensor package and identify any receiver or transmitter you already use. Tell the pharmacy if a different system has been prescribed. Ask whether an old authorization remains open and whether it must be changed rather than duplicated.
A sensor that fails early may require a manufacturer support request. A normal replenishment is handled through the dispensing and benefits process. Keep case numbers for both conversations and explain that they concern different events. If you may run out of monitoring supplies, contact your treating team for an appropriate plan rather than relying on a delivery estimate from this website.
What Florida members should confirm before a transfer
Ask the proposed dispenser to confirm its participation in your Medicaid program or plan and its ability to handle the prescribed system. Ask your existing pharmacy about any claim or shipment already in progress. Keep the process coordinated so two providers do not attempt to supply the same period.
If you have other insurance, ask the pharmacy which payer should be billed first. If a child is involved, have the clinician verify pediatric considerations and the exact device’s age requirements. For a disputed decision, use the notice’s review instructions and deadlines. A product being listed on a public supplier website does not resolve these questions.
MedraxDME is an out of network supplier. This educational page does not establish Medicaid enrollment, a contract with your plan, or your eligibility to receive equipment from us. Confirm the dispensing provider with your program before transferring a prescription. Our online form requests contact details and optional equipment selections. Do not enter insurance numbers, medical records or glucose readings.
Questions and answers
Does the preferred list mean every version of a CGM is approved?
No. The dispensing pharmacy should check the exact product, prescription, applicable limits and your benefits.
Do sensor and receiver limits mean the same thing?
No. AHCA lists them as different components with different limits. Ask the pharmacy to review each requested item.
Is this an enrollment page for Florida Medicaid?
No. It is an educational guide. MedraxDME’s ability to bill your program must be separately confirmed.
Sources and updates
- Florida Statute 409.9063, Medicaid CGM coverage
- AHCA preferred diabetic supply products, October 2026
- AHCA pharmacy policy resources
Read our editorial and correction policy. For current plan rules, check the applicable official policy and contact your plan. Tell us about a correction.