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Blue Shield of CA experiences?

Discussion in 'Insurance Issues' started by namegirl, Dec 2, 2013.

  1. namegirl

    namegirl Approved members

    Mar 26, 2011
    Our insurance is being cancelled due to the ACA, so we are shopping around. I've found some Blue Shield of CA plans that seem good. I'm wondering if anyone has experience getting a CGM with Blue Shield CA? Or had any limitations on insulin brands or pump companies?

    Thank you!
  2. Don

    Don Approved members

    Sep 23, 2010
    I use Blue Shield of CA and Dexcom is covered for me. The Dexcom rep looked into it and told me Blue Shield's contract with Dexcom was such that the kit would be $1308 x 50% copay=$654 (deductible already met) and sensors would be $68.68 x 50% copay=$34.34 each. (I elected not to pull the trigger due to cost). I've looked at Blue Shield's plans at the California Covered website and I love the super low DME copays, Platinum is 10% and Gold is 20%. I figured out that it would be worth getting off my wife's employer plan and getting the Gold plan if I were to use Dexcom in addition to pump. Re insulin, I get Humalog at the regular copay. I bought my minimed pump used but I don't see any reason to doubt that Blue Shield would cover new pumps. They cover my supplies no problem. I like that Blue Shield's charter requires that their profit be limited to 2% of revenues.

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