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Conditional

Requires Letter of Medical Necessity (LOMN)

Is Dexcom G7 CGM System FSA/HSA Eligible?

Brand: DexcomCategory: Glucose Monitoring

Retail Price

$300

You Save (Pre-Tax)

$90

Your Cost (After Tax Savings)

$210

* Based on 30% marginal tax rate. Adjust your rate below for accurate savings.

How to Get Approved

With diabetes diagnosis - typically eligible without LOMN. For non-diabetics: requires metabolic disorder or obesity treatment documentation.

The Fast Way

Don't have a doctor?

Get instant approval online for $30. Skip the appointment — a licensed physician reviews your request and issues your LOMN within 24-48 hours.

24-48 hour turnaround
Board-certified physicians
Get Instant Approval — $30

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Free LOMN Template

Copy this template and bring it to your doctor. They'll need to customize it with your diagnosis and sign it.

LETTER OF MEDICAL NECESSITY Date: [DATE] To Whom It May Concern, I am writing to certify that Dexcom G7 CGM System is medically necessary for my patient: Patient Name: [PATIENT NAME] Date of Birth: [DOB] Diagnosis: [ICD-10 CODE AND DESCRIPTION] Medical Justification: With diabetes diagnosis - typically eligible without LOMN. For non-diabetics: requires metabolic disorder or obesity treatment documentation. I have prescribed this item as part of the patient's treatment plan, and it is not for general health or cosmetic purposes. If you have any questions, please contact my office. Sincerely, [PHYSICIAN SIGNATURE] [PHYSICIAN NAME, MD] [PRACTICE NAME] [NPI NUMBER] [PHONE NUMBER]

Submit the signed letter to your FSA/HSA administrator along with your receipt.

Tax Savings Calculator

Retail Price

$300

Tax Savings

$90

You Pay

$210

By using FSA/HSA funds, you're paying with pre-tax dollars. This means you effectively save your marginal tax rate (30%) on every purchase. The higher your tax bracket, the more you save.

Quick Facts

Status
Conditional
LOMN Required
Yes
Category
Glucose Monitoring
Price
$300
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