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Insurance Coverage for CGM

Discussion in 'Insurance Issues' started by Jeff, Apr 2, 2008.

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  1. Jeff

    Jeff Founder, CWD

    Joined:
    Jun 1, 1995
    Messages:
    1,522
    If you've received insurance coverage for a continuous sensor, please note it here. Include:

    - Insurance Company
    - State
    - Sensor
    - Age of person with diabetes

    It's time to start collecting this data and sharing among our families.

    (We're still waiting to hear from our insurance company.)
     
  2. bkfkmc

    bkfkmc Approved members

    Joined:
    Feb 25, 2006
    Messages:
    675
    United Healthcare River Valley
    State of Tennessee HMO plan
    Minimed CGMS
    Age 7

    Note: Before this year we were on the Cigna State of TN POS plan. I fought for 14 months for coverage with repeated denials. It seemed to be a dead end.
     
  3. azkat

    azkat Approved members

    Joined:
    Nov 20, 2007
    Messages:
    41
    United Health Care PPO
    Arizona
    minimed CGM
    age 3 when she received it :D
     
  4. HannahB

    HannahB Approved members

    Joined:
    Jan 4, 2007
    Messages:
    64
    we recieved coverage for the dexcom when we lived in connecticut from BCBS. when we moved to LA we began using the Minimed CGMS real time system with united and also recieved coverage.
     
  5. Connie

    Connie Approved members

    Joined:
    Oct 24, 2007
    Messages:
    11
    Humana (employer is self insured)
    Ohio
    Minimed CGM
    Nick was 10 when he got it
     
  6. Mama2H

    Mama2H Approved members

    Joined:
    Oct 19, 2006
    Messages:
    4,236
    First Administrators (Self insured through the county my dh works for)
    Iowa
    Minimed Real time cgms
    Hailey was 10 when we recieved the sensor

    We were initionally denied, after speaking directly with our agent and sending in proof that it is no longer "experimental" we were approved. The agent did go to the board of supervisors in charge of dh's department for approval.
     
  7. OSUMom

    OSUMom Approved members

    Joined:
    Sep 10, 2006
    Messages:
    5,324
    We've been told it's approved - the sensor is not received and paperwork is not all done because we're waiting until June when Dean is home and the sensors are fresh. I will update if there are glitches. We've shared with other families we know who have diabetes and work for the same company.

    BCBS of Delaware EPO (local Anthem)
    Delaware (home office of employer) though we live in Ohio
    Minimed CGM
    20 years old
     
    Last edited: Apr 22, 2008
  8. Paige's Dad

    Paige's Dad Approved members

    Joined:
    Apr 7, 2007
    Messages:
    32
    BCBS of Kansas City
    Live in Kansas, insurance is in Missouri
    Medtronics Real Time System
    Paige is 10
     
  9. pdxmom

    pdxmom Approved members

    Joined:
    Feb 15, 2008
    Messages:
    54
    United Healthcare PPO
    Oregon
    Minimed CGM
    9yo
     
  10. jules12

    jules12 Approved members

    Joined:
    May 26, 2007
    Messages:
    2,333
    BCBS of Kansas City
    Missouri
    Minimed CGM
    Josh is 8
     
  11. dragonblimps_mom

    dragonblimps_mom Approved members

    Joined:
    May 25, 2008
    Messages:
    113
    Care First BC/BS
    Maryland
    Freestyle Navigator
    Amelia is 10 years old

    We haven't received it yet. Abbott is still arranging it's durable medical equipment distributors. I hope they hurry. We have an appointment with the CDE on June 18th for training and startup.

    We got 100% coverage because I have PPO. It appears they consider POS as "out of network" and only cover 80%. They didn't say if it's covered under HMO or not.
     
  12. Chaser

    Chaser Approved members

    Joined:
    Jul 28, 2007
    Messages:
    226
    Optima Family
    Virginia
    Minimed CGMS
    2 years old
     
  13. chocoholicsc

    chocoholicsc Approved members

    Joined:
    Apr 1, 2008
    Messages:
    1,030
    Blue Choice of South Carolina
    South Carolina
    Minimed CGMS
    Christopher is 2 years old
     
  14. Brensdad

    Brensdad Approved members

    Joined:
    Dec 27, 2005
    Messages:
    2,383
    United Health Care Open Choice PPO
    Texas, but I think the plan is hosted at our corprate office in Pennsylvania
    Emma was 2 when it was approved.
    Minimed CGMS
     
  15. khoward1017

    khoward1017 Approved members

    Joined:
    Jun 4, 2007
    Messages:
    108
    We just got the Dexcom Seven System. We have United Healthcare. We are from Ohio. It covers everything 100%...but we had to go through a third party supplier, Edgepark Medical Supply Company becuase United Healthcare has a contract with them. If we ordered straight from Dexcom then insurance would only cover 80%. It took us about 6 weeks to get the product. It required pre=approval on all durable medical devices over $1000.00. My dr. just had to complete the documents to prove this was necessary. My son just turned 6. If you need any more information, just let me know!

    Karen
     
  16. 4MyBoys

    4MyBoys Approved members

    Joined:
    Feb 23, 2008
    Messages:
    234
    Excellus BSBS (New York State Child Health Plus)
    New York
    Minimed CGMS
    9 years old

    We had been paying for it out of pocket for several months, because I was not up for the insurance fight. It was so easy, it was approved in three days, no fight, no phone calls, etc. I worked with Melanie McMorrow at MiniMed.. She knew "the code!" -Allison
     
  17. bgallini

    bgallini Approved members

    Joined:
    Feb 23, 2008
    Messages:
    3,950
    Anthem BC/BS of VA (COVA Care PPO)

    We don't actually have it yet but we've been told that they will approve it if we have 30 days of meter readings with at least 4 tests per day AND at least one reading under 50 w/in those 30 days.
     
  18. Stacey Nagel

    Stacey Nagel Approved members

    Joined:
    Oct 23, 2005
    Messages:
    579
    Group Health In of NY (GHI)
    New York
    Freestyle Navigator
    16 :cool:
     
  19. TEXSONMOM

    TEXSONMOM Approved members

    Joined:
    Jun 10, 2008
    Messages:
    845
    Summerlin Life and Health Insurance
    MM Pump 03/07
    CGMS - 10/07 - approved immediately with Doctor letter
    Las Vegas, Nevada
     
  20. WestinsMom

    WestinsMom Approved members

    Joined:
    Mar 27, 2007
    Messages:
    3,137
    I just received reimbursement from BCBS of Michigan (MICHILD). "After further review of the claim and supporting medical documentation, we have determined this service is payable."

    :)

    ETA on Jan 9, 2009: Though we got reimbursement, we have yet to be able to get preauthorization. We have not reordered yet to test for a repeat payment.
     
    Last edited: Jan 9, 2009

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