Has anyone wanting a CGM who has been denied coverage by their insurance company seen this recent Consensus Statement by the American Association of Clinical Endocrinologists? It may help in framing your arguments to the insurance company. Based upon a variety of conditions (frequent hypos, both high and low a1c levels, glucose control, etc.) the association essentially acknowledges that all persons with diabetes qualify as candidates who would potentially benefit through CGM use. Link is posted below-large file, though! Email copies of the link to your PCPs if you can!
PS: I am a school nurse who has been working on a master’s degree. My loving wife would not allow me to go away to school this past summer without a CGM, because she knew that I’d be at risk for nighttime lows and she would not be around to help me. My monitor worked wonders there. I had no hypoglycemic events during 5 intense weeks of studying full-time during the days, then doing research and writing every evening until midnight. Acquiring the CGM turned out to be a serendipitous event, as I chose to use the device as part of my master’s project.
After learning about all the hassles getting insurance approval that folks documented here, I chose to work on, “A strategy to increase the use of cgm among school children with diabetes.” I’d love to hear any input from tuD users related to their trials either with obtaining, learning about or trying to teach their school nurses how to interpret (or not freak out over) CGM results. Please post your experiences in response to this discussion. For those who are expert with this site, can you tell me whether this is the best way to access input from users? I may also be interested in posting a survey on the site. Is that easy to do? (I’m a bit late for that approach because my rough project must be finished by December 10.)
Thanks to all for any help that you can provide!
http://www.aace.com/pub/pdf/Continuous’GlucoseMonitoring.pdf
my authorization for the CGM is good until November 14th. The starting date was a few days before the submitted the paperwork! Which was October 14th. I am getting my CGM tomorrow. So I have to figure out what to do now. By the time Im up and running, the authorization will expire. So I have to find out how to extend that authorization so I am able to get supplies and what not as I cant pay out of pocket at all.
Amy, most supply companies send a 3 month supply of sensors. My insurance company requires pre-authorization before sensors are shipped, but so far, it has not been a problem getting them. I was originally turned down & had to appeal that decision. The first hurdle is usually the hardest part. Since you did not have yours denied first, getting the supplies should not be too hard for you.
Hi Amy. Is it a real-time CGM, or a blind one where it just saves the results for your MD to analyze with you after the 4 weeks? If it has a full display of trends and numbers and you’ve only qualified for a trial period of 4 weeks, try to use the trend data to keep your blood sugars as close to the normal range as possible without getting low (you probably do this anyway, but the CGM will give you a lot more power using the trends and alarms). Then the doc can vouch for how much it has contributed to your control & safety & you will have evidence to support how beneficial it would be for you to have it full-time. As someone else on this site said, happy obsessing!
Bob, click the contact us link at the bottom of any page to send feedback to our administrative team with details about what kind of survey you wish to do. We will generally approve clinical, non-market, not-for-profit research conducted by reputable university programs.
I found several publications like that and sent them to my insurance company. They paid some doctor money to say that, well, it was my fault I had so many lows (it was, but it still doesn’t take away from the fact that I got low), so they weren’t giving me one. God, insurance companies are the scummiest things on Earth. (Okay, maybe not. Maybe my sugars dropping and annoyed, but I can’t tell, because I don’t have a CGM. $^@@$ers.)