I have just filed my first appeal. I found out on Friday that my request for a CGM was denied on the basis of “he must prove he is a danger to others”. As I drive everyday and frequently long distances this should not be a problem. I am stunned at the idea of needing to be a danger to others. I guess I am not important enough.
They aren’t liable if I cause an accident I am. They only have to pay my costs. I have to pay everyone elses. This excuse is ridiculous.
Sorry I’m venting. Let me know if this kind of denial is normal. I expected to have to file a few appeals but the reason for this one is dumb!
Show them logs with at least three lows in the last two months. Explain that you drive for a living.
Frequent lows + driving for a living = danger to others.
I’m just saying.
Terry
That’s what I did. After watching a few other discussions that seemed like the logical approach. I don’t drive for a living however I log about 30,000 miles a year. When I am working it is part of my job, driving from one site to another, but I have been out of work since Feb. Lovely economy. Anyway, I was able to show them 2 recent driving lows and one more dangerous from years back. As well as night time lows every 6-8 weeks several of which I get low enough to seizure. Despite testing before driving as I am getting lower(better) numbers I am dropping to low at times.
Thank you Terry for your input!
Well I guess I put that in the wrong spot. Terry look above for my response, thanks again.
Thanks, Mark!
Huh. My doctor told me that no insurance company will provide coverage for a CGMS. Since I get low and have seizures several times a week, I feel like I should have one, but I totally can’t afford it…
Several insurance companies are paying for them. But you have to prove you need it. Like Terry said it usually amounts to showing you are trying hard but still can’t tell when you are going low. In my case the excuse for the first denial was I have to prove I am a danger to others. I expect to be denied at least once more. It all depends on the company. I understand some are providing them without denial. If you go low enough for a seizure on a regular basis and can prove it with Emergency room visits or 911 calls then you could be a canidate.
In my case my wife has stopped calling 911 because she can treat the seizure although I don’t suggest self treatment. Anyway that makes it hard to prove necessity. I have only had 911 called like 2 times in the last 6 years but have had about 12 severe seizures and several smaller ones. If I could show them that I think it would be easier to get the CGMS.