Here is what I believe:
Type 1 Diabetics should NEVER be denied coverage for CGM systems.
Her is what I need help on:
Give me ways to support this statement.
History: I’m a type 1 diabetic that has been fighting this disease since I was an infant and Im having such a hard time getting approval for a CGM system. I DONT believe type 1 diabetics should ever be denied coverage for something as amazing as the CGM system.
I’m no fan of the insurance industry. People who have a bona fide need for a CGM, should be fairly considered. But, not realistic that everyone should be approved. They’re expensive devices that aren’t that accurate. What I’d like to see are CGMs for rental or loan for 2-3 months. This would help people without the huge expense of owning & supplies.
I sooooo agree with you Gerri.
Absolutely. If your A1C is terrific, and you feel your lows and dont need emergency assistance, you are probably doing great without one.
When I am concerned that my HMO has lousy pump coverage under my plan, I remember the meters I sent to Russia with a medical team once. The towns they were going to were going to have one meter per town, where diabetics could check their bg maybe a couple times a day.
I think we’re spoiled.
Not against these devices for people who need them, but not all need or even want them.
How awful to dole out one meter per town! Yes, we feel entitled as if it’s a right. Pumps & CGMs aren’t magical routes to control. Not saying they don’t help, but they’re not going to do the work for us.
What’s tragic is people having strip limitations. That’s wrong.
Yes, and my pharmacy questioning why my Endo writes my insulin for two vials a month.
Stuff like that.
But new technology, I dont know…
Geesh, as if it’s pharmacy’s business. I’ve heard this before & don’t understand their right to question anything.
I agree completely, Desiree! T1 is difficult enough without insurance company hassles. The peace of mind from CGM reminds me of what life used to be like before dx which, of course, you don’t remember being an infant at the time. Spontaneous eating and activity and feeling normal are gone from my life. Anything that can make this hateful disease more manageable should be automatic.
Sorry to hear about your parents Alan. They are very strong.
I guess maybe I did not think of the people who dont have much. My apologies for making this post sound a bit spoiled sort of speak. I recently got denied for the CGM and I decided to come on here and share my frustrations. I just want to let everyone know I’m sorry for being a brat but I still believe that Type 1 diabetics shouldnt be denied for something that could help them. Im 22 and I live alone, I think a CGM would be a great companion. I will continue to fight for it.
and if you dont want it then dont ask for it! its just like an insulin pump not everyone wants it.
Wow, thank you so much for agreeing with me. I felt so attacked in this post! LOL, I recieved a letter saying I was denied for the CGM and was upset and wondering why such a wonderful useful tool that could save my life was denied. Thank you again Don.
Hahaha! which does not exist here in the states. Im not asking for them to pay 100% but to atleast help me a little considering im a low income college student in debt with college! phew! I guess Im only wishful thinking here. Thank you for you reply to my post.
rental CGM, good idea!
I wonder too with all the complaints about the rising costs of health care why something that should help both T1 and T2 and LADA’s stay healthy would be denied. Would it not be more cost effective in the long run to prevent complications than to have to treat the complications as they arise and become in many cases so severe that total support is needed to care for the person? I would think it should be a no brainer - pump and CGM available for all diabetics!
I couldnt have said it better. When glucose meters first came out it was exactly like this! the meter over $600 and test strips over $50 each. Im hoping that eventually the price will drop so we all can benefit from this wonderful technology. T1 & T2 for better control! Thank you Korrie.
I think the only thing that will help is if costs come down for the CGMs and if the ADA comes out and says that this is a real necessity for people with T1. There was a time when home glucose monitors were expensive and not really considered a necessity. Eventually costs came down enough to make them widely available to everyone, T1s and T2s. While I know many insurance companies will limit monthly test strips, getting a home meter is now standard. I think the same will happen with CGMs. Once their costs are down (which happens with all technological innovations), they will be easier to obtain.
Pump costs have not ever come down…they’ve been holding steady for years.
Big issue with all devices is how expensive supplies are & the cost of supplies hasn’t come down for consumers.
try and get a dexcom in Canada - Universal Healt Care is not all its cracked up to be.
Yes blame the insurance companies generous benefits. When insurance companies will pay 6ooo a pump, guess what the cost of a pump is - There is no competition. Yet when I was buying out of pocket without insurance, I was able to turn in an old deltec cozmo for a new animas for 200 - do you really think the pumps cost 6000???
If there were no insurance, all medical care would be cheaper and companies would have to compete for our business. No I am not advocating for no insurance, but some of the market based reforms being advocated will encourage cost containment on medical care - I think they will do it with lower copays buy selecting more cost efficient care and higher copays on more expensive care. (As opposed to Obamacare which will add taxes to durable Medical Equipment) Take a hospital visit for example - no one with insurance checks prices froim hospital A vs Hspital B. But when we buy a car - we check out quality and cost and will frequently travel 20 or 30 miles further away for a better deal. Why shouldn’t we shop for medical services. I believe that costs will come down once the providers have to compete with one another.
Uhmmm still cant get it in Canada and we get it here even wit the damned FDA! Not misrepresenting anything facts are facts
Also look aty utilization rates of Insulin pumps - “However, the use of insulin pump therapy varies markedly throughout the world; there are some notable high-use countries, e.g., the U.S. and Israel, where it is estimated that ∼20% of type 1 diabetic patients use CSII (manufacturers’ estimates), whereas in other countries, such as the U.K. and Denmark, ∼1% use pump therapy (3). " http://care.diabetesjournals.org/content/29/6/1449.full”