Aetna PPO Texas MM CGM For Myself After showing a log of Bg numbers for 3 months--Testing AT LEAST 4 times a day, as well as mnay readings under 50 during the night
Aetna HMO NY Minimed 14 YO Denied at first, then reversed after the first appeal. We had to prove repetitive hypoglycemia even with multiple glucose checks on a daily basis.
First won on appeal: Great West Healthcare PPO CO MiniMed MiniLink Age 11 when approved Changed companies and won again: BCBS TX MiniMed MiniLink
BCBS of Illinois? Does anyone have coverage for CGMS with BCBS of Illinois? Help is much appreciated. Jay daughter Julia with type 1.
United Healthcare PPO Illinois Dexcom 22 years old (had this company before the start of the new year, and we were 100% covered through Edgepark DME) Also, just switched companies and was told by both the new company AND Dexcom we would have 90% coverage after a deductible is met... Anthem BCBS of Illinois Illinois Dexcom 22 years old
IMG (International Medical Group - imglobal.com - Not for US citizens living in the US) world wide coverage MM Guardian 2.5 years old
Oxford Health (A Division of UnitedHealth Care) California (insurance contracted by parent company in NY though) Dexcom 7 2 years old We received prior auth and were told we were covered at 100% after meeting our deductible. However the claims department denied the claim as "not a covered service" and are currenltly investigating and reprocessing claim. Sadly we paid OOP figuring it was towards our deductible and now we have to wait for reimbursement. Ugh! ETA** As of today it has been covered under Oxford at 100% after our deductible. They claim it was filed wrong under ?home health? was the reason for the original denial. On May 1 we are changing to Great West Healthcare PPO so I am pleased to see they have granted approvals to others, and hope we can continue to get coverage!
- CIGNA HMO - Virginia - Navigator - 4-year-old T1 diabetic Approval was received after submission of paperwork and LMN from Endo on first submission - 5 business days!
United Healthcare Georgia Two diabetic children approved on first request from doctor one week. 11 years old (last year) August 2008 Navigator 9 year old September 2008 Navigator
United Healthcare - Florida POS 10 year old - needed to show lows below 50 Dexcom 7 plus 80% coverage
Aetna - OpenChoice PPO California Minimed CGMS (Minimed had to submit the paperwork to Aetna) 8 years old Had to show lows below 50 - diagnosis code 250.83
- HAP Solo - Michigan - Dexcom 7+ - I am 25 I have an individual plan through HAP and they covered my CGMS at 100%. No hoops to jump through either!
BCBS of Mississippi State Employee Plan Dexcom 10 year old T1 on Animas pump Only covered at 60% as it is out of network We are waiting for better coverage since our #'s are pretty good.
Badger Care and the CGM I Have been contacting my congress person. There is actually a department that deals directly with diabetes and other health issues. This department deals directly with medical things that are not covered with state insurance. The more people who do this the sooner it will be covered. I even had my rep from medtronic mini med send in reports on people who have been on the cgm and what their A1c was before and after. This is what the board looks at when determining if a product or medication should be covered by state insurance. So please write, call, email your congress person. There is a need for this device to be covered. I am in WI, so I am sure every state and county are different.
CGM Insurance Coverage Insurance Co: SISCO (covered 90%) State: Iowa Sensor: Dexcom Haley (15) Dx: 2-2009 I had minimal problems with my insurance company and the CGM. Haley's Physician told us right away that with her A1C at 5.5 and her BG numbers within normal limits that the insurance would most likely deny it. He is even surprised with this decision but thankful that they are beginning to see the benefits of this more and more.
