Requirement(s)

Reimbursement Criteria and Maximum Reimbursed Quantity: All ODB eligible recipients on insulin therapy for diabetes who have a valid prescription from a physician or nurse practitioner for CGM sensors and/or a CGM reader/receiver designated on the Formulary are eligible to receive the prescribed ODB-funded CGM sensors and/or reader/receiver. Patients who meet the reimbursement criteria are eligible for a maximum reimbursed quantity of 31 sensors over the course of a 365-day period. Please refer to the Ontario Drug Programs Reference Manual for more information related to CGM systems (e.g., pharmacy billing procedure, HNS response codes and messages).