This has been such an issue for us too...after six months of fighting the insurance co we got approval from talking on the phone with the right person. Darn it for taking so long to figure out who the "right" person was....so what I would do differently is write the letter to the insurance company appealing right away, have your endo right a letter of medical necessity right away, call right away and ask to speak to the person in charge of the pharmaceutical service department and NOBODY else, speak candidly about what happens to your child due to lows/highs both currently and long term effects, contact your state insurance commissioner (you can do this online) and they will contact your insurance. Let them know from the start that you are a pain in their ass that won't go away until they cover your child for the necessary medical equipment that they need. DAMN this topic gets me fired up, why do we need to fight for test strips. Wanna hear the real crap part of it for us - now that we got approval my husband's company switched insurance co's and we get to start all over. YIPPEE!