Anyone had any luck w/ Aetna coverage on CGMS?

They ‘supposedly’ changed their policy on CGMS (as of June 20) and are allowing it for continual use under certain criteria. MM has gone ahead with the predetermination process with Aetna (which they were NOT doing before) they said it would take a couple of weeks. I was SO excited to see they had changed their policy–I already had two denials from them. I am not feeling so hopeful now, though. I read a couple of posts where CGMS claims have been denied since 7/1–even with patients who met all criteria. I think I am going to start collecting data from websites where it states that Aetna is now covering it ( )so I can throw it back at them when they deny me, because I feel sure I’m going to get another no.

Wow crazy you should post this. I fought and won an appeal with my insurance for my CGM (6 months) then the new year our company changed to Aetna, so I just assumed my CGM would be paid for and ordered more sensors, but ya know what, I handed in all my paperwork and never heard boo from Aetna. I am calling them sometime this week to find out where my money is at, I will let you know what happens, but I am already p.o.'d reading this, that they don’t cover and I hope, hope, hope, that I don’t have to do the appeal thing again. I forget what I did. :wink: Another odd thing is I stopped using the CGM, was a bit frustrated with it, and today I decided to try it again, and it worked perfectly so now of course I am up for the appeal fight. Thanks for posting.

Well Marcy, I called Aetna today, and guess what, just like my other insurance they stated they never received my claim, I almost took, omg, her name was Fawn’s head off. So I had to fax the claim in and she said it takes 45 days to process, lordie. I said how will I know they won’t lose my fax or say that they never got it, ooo just call in 48 hours to check.

Here we go!!!

I got an automated UPS shipment from MM today…I couldn’t believe it was shipping! Checked MM order history and forgot that I had signed up for the automatic shipments for pump supplies. I was horribly disappointed! But then I checked order status again just a few minutes ago and now it is showing an order for the CGMS as of the 14th and it states the order is “in process” and is “to be shipped” with my payment to be less than $100! Is it really going to go through, or are they just waiting for a response from MM? Can I start dancing? Ohh wait, I don’t want to jinx it…