Medicare 2026

Medicare's 2028 Competitive Bidding Round: What CGM and Insulin Pump Users Should Know

If you use a continuous glucose monitor (CGM) or an insulin pump through Medicare, a change is coming in 2028 that will affect where you get the device and how it's paid for. Medicare's Competitive Bidding Program, which already covers many types of durable medical equipment, is being reshaped by a CMS final rule published in the Federal Register on December 2, 2025. Starting January 1, 2028, CGMs and insulin pumps are included in a new nationwide Remote Item Delivery program, along with urological supplies, ostomy supplies, hydrophilic urinary catheters, and off-the-shelf back, knee and upper extremity braces.

Here's a plain-English walk-through of what's changing, what isn't, and what to watch for.

What Competitive Bidding is, briefly

Under Competitive Bidding, suppliers submit bids to Medicare to furnish certain Part B items, and CMS awards contracts to a limited group of suppliers. The idea is to use competition to set payment rates for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The next round, Round 2028, is different from past rounds in one important way: it is nationwide, not tied to geographic bidding areas. CMS calls this a Remote Item Delivery program. The included items can be shipped to your home or picked up at a local pharmacy or storefront owned by a contract supplier or its subcontractor, wherever you live in the country.

The timeline

CMS has set target dates for Round 2028:

• Bidder registration: December 1, 2026 to February 1, 2027.
• Bid window: January 5, 2027 to March 10, 2027.
• Contract supplier announcements and beneficiary education: late summer or early fall 2027.
• Contracts take effect: January 1, 2028.

These are target dates, so expect them to be confirmed as the round progresses.

What changes for CGM and insulin pump users

Beginning on the first day of the contract period, Medicare will pay for CGMs and insulin pumps as continuous monthly rentals. The monthly rental payment includes all the supplies and accessories you need. Contract suppliers keep ownership of the rented device, and they must furnish the brand of CGM or insulin pump that your physician ordered — so your prescriber's choice still drives which device you get.

Contract suppliers must also:

• Submit claims on an assignment basis (meaning they accept Medicare's approved amount as payment in full, aside from applicable cost-sharing).
• Offer Medicare patients the same range of products they offer non-Medicare customers.

CMS will post a list of brands each contract supplier furnishes. You'll be able to look up suppliers and brands through Medicare.gov and 1-800-MEDICARE.

If you already own your device

If you own your CGM or insulin pump before the contract period starts, you can keep using it until it needs to be replaced, or until you decide to switch to a rented device. Contract suppliers must furnish replacement supplies and accessories for devices you already own. Repairs of equipment you own can come from either a contract or non-contract supplier.

The six-month grace period

A six-month grace period beginning January 1, 2028 gives contract suppliers time to obtain the written orders needed for patients switching from non-contract suppliers. A few things to understand about this grace period:

• It is not a window in which non-contract suppliers can keep furnishing these items.
• It does not apply to purchases of off-the-shelf braces.
• If your previous supplier does not pass along the needed documentation to a contract supplier, you may need to visit your physician for a new order.

If you currently use a non-contract supplier, it's worth asking them now how they plan to transfer your records.

Part B vs. Part D — and a note on Medicare Advantage

Competitive Bidding applies only to items covered under Medicare Part B, not Part D. If you get coverage through Medicare Advantage, your plan sets its own supplier network rules; check with your plan directly about how it will handle these items in 2028.

Other 2027 numbers to keep in mind

While you're planning, a few program-wide figures for 2027 are already set:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026).
• The highest deductible any Part D plan may charge in 2027 is $700.
• The Part D base beneficiary premium used in the late-enrollment penalty calculation is $41.33 for 2027; actual plan premiums are set plan by plan.
• Social Security announced a 3.6% cost-of-living adjustment for benefits payable beginning January 2027.
• Annual Enrollment for 2027 runs October 15 – December 7, 2026.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not yet been announced; CMS typically releases them in the fall.

A quick note for people with Medicaid or Extra Help

Since 2025, people with Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated D-SNP in any month.

Choosing between coverage paths

If you're weighing Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) against Medicare Advantage, both have trade-offs. Original Medicare generally lets you use any provider that accepts Medicare and keeps supplier choices under federal rules like Competitive Bidding; Medigap can help with cost-sharing but has its own rules for enrollment. Medicare Advantage plans often bundle drug coverage and extra benefits, but use networks and plan-set rules for supplies and devices. There's no one-size-fits-all answer — the right fit depends on your health, your prescriber, and your budget.

Where to go for official information

For official details, supplier lookups, brand lists once posted, and help understanding your options, use Medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), available 24 hours a day, 7 days a week.