How to Navigate NYRx Medicaid & Medicare for CGM in Brooklyn 2026
- intake988
- Mar 24
- 2 min read
Updated: Apr 6
Transitioning to NYRx: What Brooklyn Patients Need to Know
As of March 2026, the New York State Medicaid pharmacy program (NYRx) has streamlined the coverage for Continuous Glucose Monitors (CGM). If you are a Medicaid member in New York City, your CGM benefits are now handled directly through NYRx rather than a managed care plan.
From our headquarters in Borough Park, we help patients across Williamsburg, Crown Heights, and Midwood navigate the complex 2026 NYRx transition.
Eligibility Criteria for Zero-Out-Of-Pocket CGM
To qualify for a Dexcom or FreeStyle Libre system through NYRx, the following concrete medical facts apply:
Diagnosis: You must have a diagnosis of Type 1, Type 2, or Gestational Diabetes.
Insulin Requirement: You must be on an insulin treatment plan or an insulin pump.
Doctor Coordination: You must have had a face-to-face visit with your prescriber within the last 6 months to confirm the medical necessity of the device.
Medicare Part B Coordination For dual-eligible patients, Medicare Part B remains the primary payer, covering 80% of the cost. At Palma Care DME, we coordinate the remaining 20% through NYRx or your supplemental insurance to ensure our patients often pay $0 out-of-pocket
Are you 'Dual-Eligible' with both Medicare and Medicaid? Palma Care DME specializes in coordinating these benefits, so you have $0 cost-sharing. We handle the 80/20 split automatically.
Why Choose Palma Care DME for Your Supplies?
Navigating medical supplies shouldn't be a DIY project. At Palma Care DME, we provide personalized support for our neighbors across Brooklyn, Monsey, and all of New York State.
$0 Out-of-Pocket: We specialize in 2026 NYRx Medicaid and Medicare coordination to ensure eligible patients pay $0.
We Handle the Paperwork: Our team manages the prior authorizations (PA) directly with your doctor.
Fast 2-Day Delivery: We deliver right to your door in Williamsburg, Borough Park, Spring Valley, and beyond.
Expert Support: Have questions about the Dexcom G7 or Libre 3? Our specialists are just a phone call away.
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