FreeStyle Libre 3 Hospital Discharge Program
No, patients cannot routinely receive FreeStyle Libre 3 for free at hospital discharge through a standard Abbott complimentary program—CGM coverage requires insurance authorization or out-of-pocket payment, though some hospitals may provide temporary sensors during the COVID-19 pandemic for remote monitoring purposes. 1
Insurance Coverage Requirements
Both Dexcom G6/G7 and FreeStyle Libre systems have achieved broad insurance coverage, including Medicare eligibility, but this requires proper documentation and prior authorization—not automatic free distribution at discharge. 2
Medicare specifically requires documentation that the CGM continuously measured glucose and displayed data in real-time >95% of the time for the duration specified in the product label, with comprehensive reports and validation of glucose values documented in electronic health records to support ongoing coverage. 2
Coverage decisions should be based on thorough evaluation of patient characteristics, needs, and device availability through shared decision-making between the patient and their outpatient diabetes care team. 2
Hospital Use Context (Not Free Distribution)
During the COVID-19 pandemic, the FDA did not object to the use of continuous glucose monitoring in the hospital setting to avoid bedside capillary testing and reduce virus exposure, but this was for inpatient monitoring—not free take-home devices. 1
Factory-calibrated devices like FreeStyle Libre allow remote monitoring via intermittent flashing when paired with the FreeStyle LibreLink app (available for Android or iOS), with data accessible via LibreView dashboards for monitoring multiple patients during hospitalization. 1
Point-of-care testing remains the standard of care in hospital settings, with CGM accuracy potentially compromised during acute physiological disturbances including hypoxemia, severe dehydration, and rapidly changing glucose concentrations. 1
Cost Realities
CGM systems are relatively expensive, with real-time CGM systems generally having higher direct costs than intermittently scanned CGM (flash monitoring) systems like FreeStyle Libre. 2
Factory-calibrated systems like FreeStyle Libre do not require fingerstick blood glucose calibrations, which reduces overall monitoring costs over time, but the initial sensor cost remains substantial. 2
Clinical Eligibility for Coverage (When Prescribed)
Real-time CGM is particularly beneficial and covered for patients with hypoglycemia unawareness or frequent hypoglycemic episodes (Grade B recommendation), which would need to be documented for insurance approval. 2
Patients with type 1 diabetes on intensive insulin regimens have Grade A evidence supporting CGM use for lowering HbA1c levels, strengthening insurance coverage justification. 2
Common Pitfalls to Avoid
Do not assume hospital discharge automatically includes free CGM devices—patients need either active insurance coverage with prior authorization or must pay out-of-pocket for sensors. 2
Ensure patients have a compatible smartphone (Android or iOS) for the FreeStyle LibreLink app before prescribing, as the sensor alone is non-functional without scanning capability. 1
Patients must understand that high-dose acetaminophen (>4g per day), salicylic acid, and ascorbic acid can interfere with glucose readings, and that fingerstick blood glucose monitoring remains necessary for treatment decisions. 1, 3
CGM devices must be removed for certain procedures including MRI and diathermy, which should be communicated before discharge. 1