I am 100% sure that there is NO insurance with one of the needed to fulfill criteria for CGM is to be on the pump.
Most insurances require the rx be from an endo and you mustvgre a priir authorization request justifying the mmedical necessity call your insurance first to find out the dme supplier they contract with. You could also call dexcom the manufacturer on a great stand-alone unit.
That is absolutely not true both my father ond I in 2 different states got cgms without aever using or requesting a pump. I was able to discover that his lantis consistently covered him for 20 hrs we switched him to split 12 hr doses and fine tuned both his basal need and his carb and correction doses Both of us qualified on the lack of hypoawareness. My cgms showed how lantis did not really cover me optimately and from wearing it I decided to get the omnipod, and no loner had to be over 50 points high just to attempt a correction without have to eat up to the insulin
I use a Dexcom sensor, no pump. Tough to get through insurance. It took a nurse that I know, two years of fighting, to get the Dexcom through insurance. I got mine quite easily. I have a different insurance provider. After five years on a sensor alone, I am still evaluating if I have the skills to get back on a pump. I believe it introduced too many new variables for me to keep track of, but I have a lot of daily variability in daily blood sugar and virtually no predictable schedule day-to-day. Peruvianpashohi is right. Use the words, 'medical necessity,' when talking to your endo.
I used the Dexcom and the Minimed one, and there is no way I'd ever use the Minimed one again. The Dexcom unit appears to have been designed with the customer in mind, and the Minimed one was designed with the Company in mind.
Dexcom - Stays on your body. I had some issues 3 years ago with them coming off, and they sent replacements and asked for the ones that fell off. I don't know if there was a problem with the adhesive, but they gave me some ideas that I could try out, and they worked.
Minimed - The system (Paradigm) had a clip on transmitter that would get caught on your clothes if you turned too quickly (my undershirt was always grabbing them) and pull the whole thing out, and the response from MM was, "buy some IV Prep wipes from us for $20/box, and some more stuff to cover up the transmitter. It was like buying a car, and then you have to buy a bunch of Saran Wrap for a windshield (from the car company) because the designer didn't think that people would drive faster than 20 mph on a sunny day.
Trust what you see on this site as a general rule, and challenge the reps with letting you try out the devices free of charge. You have control before the sale, and after the sale, finding the sales rep, or what they promised you isn't very likely. The odds are they will be friendly, and refer you to tech support, or apologize, but the company policy doesn't "allow that".
Tamra,
If I may, remember that you are the customer, and the companies need your approval to send something to you.
Minimed has traditionally been very much a "give the customer the pump/CGM, and if they don't want it, charge them to clean it" type company.
When I was looking to upgrade my pump, they had this deal where I could try the newest pump, and I was very much leaning towards it. Then, the kicker came... "What we'll do is send you out the 508 (it was a while ago), and you have to send your pump (Minimed 507C) back to us. If you like the 508, great! We'll bill your insurance company. If you don't like it, just send it back, and pay the cleaning fee ($500)." What happens to my 507C? "We keep it."
So, the thing is they put you in a position that you have to buy their pump, whether you like it or not. Plus, most pump companies have a "trade in" allowance of $500 off the deductible, and them keeping your pump sets you back another $500.
That was 10 years ago, but in my dealing with Minimed, they haven't changed much.
Be warned against them.
Tamra,
now that you have the CGM, you should look into Afrezza's inhaled human insulin if your lungs are healthy.
It certainly does interest me. I plan to talk to my endo about it in June.
Hi there! I used the dexcom G4 for about 7 months before getting a pump, and found it incredibly useful. I love it. So I would recommend that personally. I don't know about the doctor issue though... my guess is you would be very lucky if your primary even knows what a CGM is! So you will probably need an endo on board. One thing you can do right now though is give Dexcom customer service a call. They are very good at dealing with insurance issues. If you tell them you're considering getting a cgm they will do the research for you on what is necessary for your insurance coverage, and roughly what your cost would be. Basically in my experience, the cgm provider (dexcom) drives the whole process, talking with your doctor and your insurance on your behalf.
CGM brands available now:
(1) Dexcom -- completely independent from pump (unless you get a Vibe)
(2) Medtronic -- only available with pump
(3) Flash Libre -- independent from pump, only available in Europe, no alerts
I have used both the Dexcom and the Medtronic, and the Dexcom is far superior. I have the Dexcom G4, but am considering the Animas Vibe (combo pump + Dexcom). The Dexcom is a miracle.
I use a CGM but not a pump. I prefer the combination of long acting insulin with short acting for meals. That way, I still have some basal/"background" insulin at all times, which gives me more flexibility. I felt like I could never take the pump off when I was wearing one, because I'd soon have no insulin on board. I think as long as your A1C is within range, it doesn't matter how you get there. I'd encourage you to start with talking to an Endo and simply explain you want a cgm but not a pump.
Love my Dexcom CGM. It has become an invaluable tool for me. I've used both Medtronic and Dexcom and as others have mentioned I would recommend Dexcom. Some companies have begun to integrate CGM and pump but one doesn't require the other as mentioned by a previous poster.
If you get Dexcom take a peek at the Dex forum on this site, good information. I get 20+ days out of each sensor as well. Good luck!!!