My insurance shocked me by approving the pump for me before the full 6 months of injection therapy they normally require (I think Animas managed that by playing the "she's going to get pregnant soon" card). Now, Dexcom is about to try.
The last Dexcom person I talked to sounded reasonable optimistic. "I don't know of any reason they'd deny it, as long as we really do show that you need it." But I can't help but wonder if my insurance company will really believe I need it. After all, I could get by without it by testing often. I don't have crazy lows while asleep, and the lowest I've gone so far is 40, though it was low enough to scare the crap out of me. (I'm of the opinion that it'll really, really improve my control, though. Maybe I never would have had that 40 with a CGM! Maybe I'll be able to act faster when it turns out I've eaten more or fewer carbs than my little nutrition book indicated!)
Any experience on getting a CGM based almost exclusively on pregnancy?
-Elizabeth
I do not have personal experience but I hear letters from doctors help a lot in getting insurance to approve something. I also don't think the insurance company could resonably say no, pregnancy is enough of a reason to need one! Any tool that will help you have a healthier pregnancy can only save them money in the long run.
We are getting one for Emmie soon. I think it will help for seeing trends so we won't overtreat lows and worry about her so much at night.
Good luck with the insurance, hopefully it will go as well as the pump approval.
-Meg (Emmies mom, diagnosed 10/29/09 at age 4)
Hi Elizabeth,
I'm not sure the pregnancy stipulation would equal approval, as the FDA has not yet approved use of the Dexcom on pregnant women. (I know, right? Makes no sense, but that's how it is right now.)
When I applied for my Dexcom, a letter from both of my doctors (I see an internist and P.A. instead of an endo), plus my lab work from the last few visits - documenting my high A1C's - was all that was needed to get me approved. Every insurance company is different in what they will require. If your doctor can prove a necessity for you using a CGM, you shouldn't have a problem getting approved. Bringing up that low of 40 would be a good example of where it would have come in handy.
Best of luck!
Kim