Dexcom G7 15 Day Sensor

STR N/A — Device

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: Excel (XLSX)  ·  Formulary date: Sep 23, 2026  ·  Checked: 5 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 2 - Brand Formulary — ✓ ✓ DEXCOM G7 15 DAY SENSOR TO BE DISP AT A MAX QTY OF 2 SENSORS IN 23 DAYS OR 6 SENSORS IN 68 DAYS ST | QL Step therapy: SELECT CGM AGENTS W/O USE OR W/O USE OF INSULINS, XULTOPHY 100-3.6,SOLIQUA 100-33 IN 180DAYS REQ PA; Quantity limit
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