Congratulations. You have a wonderful insurance company that recognizes the need for the CGMS. What company and state is this? Lee
If it is possible to change insurance companies I would research them and do so? Write a letter to the insurance commission and have them investigate why the CGMS is not covered. It may start a trend. Talk on the phone is not enough. Have your doctor fill out a letter of need, submit it and resubmit it. Calling is frustrating as you are not dealing with the top person. Ask in writing if you are refused for an appeal. Then send all info to the insurance commission. At least it will be reviewed by an outside party. Then a final decision can be made. Good Luck. Lee
Believe it or not, Southern California’s equivalent of Medicaid, with a secondary from United Care Medical Group. It is ‘technically’ an HMO, but I’m on SSI and P/T work in retail.
I think the approval is directly from UCMG, and they are like an HMO. It is Medi-Cal (Medicaid in other states) so I really had things ready for war… Holy CARP, this is really shocking. They deny everything usually…
cool, Gina… see our link for Jim Hirsch’s In Search Of Reimbursement: A CGM Odyssey …
this is denial with a happy ending …
#B027 And Me: An Update On A Reimbursement Odyssey
My CGMS story started off as a happy anomaly, but became Another Sad CGMS Saga
Finally received a reimbursement from Horizon Blue Cross Blue Shield of New Jersey. Still a few “glitches” to work out but it looks like all of my letters and letters from the doctor and government officials has paid off.