Was just telephoned by pump supplier and questioned about last time I had a C-peptide blood test? I asked why it was any of their business and they said that now the insurance companies here in Pennsylvania are requiring C-peptide bloodwork before any pump supplies or pumps for that matter are allowed to be prescribed. I asked them to check their records and they said that mine was 14 years ago, but it would suffice. I said OK, send me supplies then! What a “wonderful” insurance company?!?!?!?!
This was taken from
He refers to medicare but it probably applies to a lot of other ins. companies.
Insulin pumps are expensive and although many (but not all) people like them, they require a lot of effort on the part of the person using them. Pumps may initially cost up to $6,500.1 In addition, there is a monthly cost for supplies. Medicare’s policy is to provide coverage for people who will get the most benefit from the pump - those who no longer produce their own insulin. This includes people with type 1 diabetes and those with type 2 diabetes who have, over time, lost the ability to make insulin.2
Since you are taking insulin for your diabetes, it is very difficult to determine how much of the insulin in your blood comes from your pancreas. However, there is a way to do this - the C-peptide test. C-peptide (short for connecting peptide) is a protein made when the islet cells make the initial, storage form of insulin, called proinsulin. Proinsulin is split into equal amounts of insulin and C-peptide when the pancreas releases insulin into the blood. The C-peptide is also released at the same time.
Since there is one C-peptide molecule for each insulin molecule, C-peptide levels serve as an accurate, indirect measure of the amount of insulin the body makes. A normal C-peptide level is usually 0.5 to 2.0 nanograms per milliliter (ng/mL). A level less than 0.55 ng/mL “proves” to Medicare that a person is not making enough insulin.
The insurance company is Capital Blue Cross/Blue Shield of Pennsylvania and the pump supplier is Direct Healthcare Supplies.