Is anyone else having problems trying to get a CGM device?? any advice on how to get the insurance company to approve it?? Ive had the pump for like 2 months but i really want the cgm cause I exercise a lot and work in a pizza kitchen where my blood consistently fluctuates.
I suppose different insurance companies have different requirements. I had to send mine, (Anthem Blue Cross) a month's worth of finger stick glucose tests for mine, which I will hopefully receive next week. I think the trick is to have at least 5 readings below 50 mgdl in that month of tests. So if your reading is like say 52, with a 5 percent error you can write down 49... The insurance company won't count the 52 but they would count the 49 and we all know that the meters aren't that accurate so why not?
I had Anthem Blue Cross and it also helped when my endo actually recommended me having the CGM. He wrote a letter to Anthem requesting for me to get a CGM for his said reasons. They gave it to me in a heart beat and even covered it wholly, but the only thing they don't cover completely are the sites which I have to pay 50% of the costs for those.
Now I have Cigna. I'm still getting to know their limits.
Dan,
The JDRF website has an article with a lot of tips on the process of CGM approval; maybe this will help you.
http://www.jdrf.org/index.cfm?page_id=106514
Good luck!
Kim
You definitely need a letter from your endo stating how the CGM would help you and why you need it (i.e. many lows or hypoglycemic unawareness). Best of luck with your insurance company!
Also, if you've decided which brand you want, contact the local sales rep (your endo should have their name). Mine led me through the approval process which made it much easier.
P.S. Mmmm ... pizza kitchen! I would be in so much trouble! That, or maybe you never want to see pizza again?
Thanx for the info everyone..ya i do have hypo unawareness, it really sux cuz i can feel perfectly fine until Im under 60 and then I get a lil shaky but ive been perfectly alert at 22 before so i hope i can get it cause with all the exercise its hard to tell where Im at. I mean before I go to bed and it says 85 I want to know if it is going up or down so I dont over eat. Im getting a sample cgm put on for 3days in a week or so and my endo told me that should really help in getting it approved.
Thanx for the info everyone..ya i do have hypo unawareness, it really sux cuz i can feel perfectly fine until Im under 60 and then I get a lil shaky but ive been perfectly alert at 22 before so i hope i can get it cause with all the exercise its hard to tell where Im at. I mean before I go to bed and it says 85 I want to know if it is going up or down so I dont over eat. Im getting a sample cgm put on for 3days in a week or so and my endo told me that should really help in getting it approved.
Hi Dan,
I know that your located in the US but I found this very helpful as I'm going through the same thing right now. I got this information from the Canadian MiniMed site go to from minimed.ca under service and help you will find of listing of options such as CGM- and you will be given 2 options 1)reimbursement FAQs 2)Four things to help with your reimbursement -- I chose option 2 and it gave me a letter of medical necessity for my endo to fill out and a Quote from the company, Device description, Clinical study support and then I included bs results for the past month as well, just to give the company all the info that they could want to prove that they help.
Hopefully you'll get approved to have the CGM and it will improve your quality of life.
"If it's true that we are what we eat, then I am fast, easy and cheap" -- Barbara Johnson