Hi there! In early June 2020, it seems that Tricare stopped covering 90-day supplies of CGM equipment (at least for Dexcom) and will only release a 30-day supply—3 sensors. This causes obvious problems, the most serious being that Dexcom sensors and any piece of equipment routinely have glitches (bleeding, pain, simply not working right) and need to be replaced. I am just waiting for the day where my third (and last) sensor fails and Dexcom can’t send me a replacement for a few days. And that’s saying nothing of a planned vacation that hits at the end of a month.
Beyond re-wearing Dexcom sensors, has anyone had experience getting around this new rule? I asked both my distributor (Solara Medical in this case) and Tricare and both of them literally said it was the other’s decision. Cannot make this sh*&( up.
Talk about draconian rules! They come in packs of 3 - I was going to suggest having your doctor write an order for 4/month instead but they would have to be creative in justifying it and even then I don’t know that the supplier would send a single in addition. I have occasionally bought durables on Amazon or eBay. It hurts to pay out of pocket but the peace of mind could be worth the cost. Those items aren’t supposed to be sold online so you have to grab them quickly when you see them listed and hope the sale isn’t cancelled due to the nature of the items (that happened to me once but I did get my money back). Occasionally there are people on the forum who give away sensors - usually G4/G5s they have left over after an upgrade, but you never know when people have some G6s they no longer need.
My doctor wrote me an RX for the Freestyle Libre in case I’m ever in a bind. I understand they have one out now or coming soon that has alarms.
Way to Bypass Tricare BS!!
Have your endo FUDGE the script a bit! Yep, fudge the script a bit. The Sensors are FDA approved for a MAXIMUM of 10 day wear. Your DOC can write out a script that says this:
Sig:
Dexcom G6 sensor change Q7D as needed
Signed, XXXXX
AND they WILL FILL it for 4 Sensors every 28 Days.
Lol… I DO it…
T1D is expensive, we need to stick together. And help each other out!!
This works for Tricare Plus, Medicare, and some private insurance companies. (DEXCOM, actually told me this hack, and I told my doc, and it works, and I share it with everyone)
It’s not fudging, either. However many you actually need in order to get through whatever time period until you get can more without running out IS the number you actually need. IMO, your doctor can write that script in good conscience. Total number needed to keep you healthy divided by number of days in prescribed time period equals number per day. Whether you need to change them on average every seven days because each sensor reliably lasts seven days, or whether it’s because half last ten days and half get wrecked after four, you still need one sensor for every seven days.
Last year my insurance let me get a 3 month supply of CGM and pump supplies at a time. They changed this year and I can only order one month at a time! While the doctor can say I need to change infusion sets every other day rather than every three, I’m stuck/were stuck when it comes to sensors. I invest in a box from Amazon and eBay so I’ll be sure to have some extras - of course I confirm expiration dates. Those items are not supposed to be sold or bought online but for this I bend the rules.
If they’re only going to show one box a month they should start you with two boxes the very first time for safety sake.