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Are more insurance companies covering CGMS?

Discussion in 'Parents of Children with Type 1' started by Pammers, Feb 29, 2008.

  1. Pammers

    Pammers Approved members

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    I suspect I am still missing overnight lows. I need some sleep!!! For the last 4 days I've been getting up at least every 2 hours (sometimes I wake sooner or can't go back to sleep because my sleep pattern is all messed up now). I can't ask hubby to help because he's working 2 jobs now and only gets 5-6 hours sleep each night. I went through this just a couple weeks ago and thought I might be able to relax for a while.....

    I really would love to get Joey a CGMS, but can't afford it unless its fully covered. Does anyone here have theirs covered by insurance and how much work was it to get it approved?
     
  2. Brensdad

    Brensdad Approved members

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    For the most part I think people are still having to fight like crazy with mixed success to get CGMS coverage. However, now that there are billing codes available for it approval rates are going up.

    We had to fight like crazy to get Emma approved, but this week I applied for coverage and was approved no questions asked. Well, they do verify that I am testing at least 6 times per day.
     
  3. MReinhardt

    MReinhardt Approved members

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    First of all, May I suggest that you talk with your dr about doing a trial of the CGM. That will help you and your dr first.

    Second, Some insurance companys will cover them, some wont. It all depends upon who your insurance company is, and what in their legal garbage discription. If your dr deems it is necessary for the CGM he/she can write a letter of medical necessity to help you obtain coverage.

    If that fails and your insurance company still denys, appeal, appeal and appeal again. You actually have nothing to lose by appealing. The more people appeal the better the chance that everyone at one point in time will be covered.

    I dont know about Dexcom, but Minimed will allow you to make payments on a month bases. Please first ask your dr for a trial run of the CGM. Take one step at a time, this is all a process.
     
  4. momtojess

    momtojess Approved members

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    We tried to get one approved for Jessi. We have humana, and they denied it saying it is experimental. Since it is only FDA approved for over 7yrs old, I am not going to fight it. She will be 7 later this year, and I plan to try again then.
     
  5. Pammers

    Pammers Approved members

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    Thanks, Tammy I also have Humana, and while in some ways it is a blessing, when it comes to diabetes stuff they are a pain in the xxx. Joey is only 5, so perhaps I may need to be a little more patient.

    However I look forward to more insight.
     

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