Closed loop and Medicare

Sorry, no insight on the Medicare part as I am still on private insurance company.
But I am using the Tandem Control IQ system. Each and everyone has a different experience with whatever treatment plan you use. I have tried @Robyn_H and go aggressive on correction so I don’t have to do a second bolus after the pump does its first correction. So I dropped down and spent so much time in the very low category that I had to just go back to the standard protocol that is recommended. So my correction is back to 1:100 and lows have leveled out. I have found for me doing everything the company recommended has worked perfectly for me. Weight is correct, correction factor is correct, use sleep mode when sleeping and exercise mode if lower at start of walk. And I will say, for the first time in my 50 years, I don’t think about my diabetes all day long. It has been so freeing to not think so much about my diabetes. I can really go all day and never pull my pump out. No testing, no calibrating, just change the infusion set every three days. Very sweet.
You might be one of those people that might need to tweak the system to get the most out of it. You might be like me and everything works like it should. Good luck with whichever way you go.

Medicare pays for my Tandem t:slim x2 w/Control-IQ, my pump supplies, my insulin, my Dexcom G6, and my CGM supplies (transmitter, sensors).

With my Medtronic 670G, Medicare paid for the 670G, my pump supplies, and my insulin. They did NOT pay for the CGM sensors.

Both of these options are considered “closed loop” so, @lainiep, the actual answer to your question is “it depends”. Medicare will add new options as time goes on. They have requirements that the manufacturers have to meet and when they do, Medicare will cover the costs.

I should add that Medicare paid for BG test strips for 5-6 tests per day with the 670G but that number has been lowered with the Dexcom G6 to 1-2 tests per day.

Thanks, Robyn. I used to be more willing to figure this out. The way I’m feeling now is that I just want a grown up to tell me how to do it and if my insurance will cover a reasonable amount of the cost… I have my CDE appointment today. I hope she can stir up some enthusiasm.

Thanks Sally. Sounds like you’ve found that sweet spot! After enjoying the Omnipods’s wireless feature for all of my pumping life, I worry about switching to a tube, but if it could give me the stress-free control you have described, it’d probably be worth any inconvenience.

It’s the “that depends” part that gets me. It shouldn’t be so hard to figure out coverage but with so many supplemental companies, the research overwhelms me. I end up paying more for supplies than I suspect I should out of laziness. Getting good control is most important…guess I’ll just focus on that.

Luckily, my A1c has remained lower than that but after 17 years of trying, I should be feeling that I have a better handle on it vs less. Maybe my appointment today will get me engaged again.

One of the best things about control iq!!

Love a horizontal line!

You asked the question: Will Medicare pay for closed loop? If you change your question to: Will Medicare pay for <specific brand pump>, <specific brand CGM>?, then there are already multiple answers in this thread.

There currently aren’t a lot of choices for closed loop systems. In a year there may be more and even more the year after that. If you want to get started now, pick one and start the process. The answer to the Medicare question will happen early on in the process.

This is still true, Medicare does not cover Medtronic sensors, but Medtronic did recently start a lower cash price offer for medicare users.

While Medicare did not pay for the old Medtronic pump I use for do-it-yourself Loop, it does, however, pay for my Medtronic infusion sets, pump reservoirs, insulin, CGM sensors and CGM transmitters.

From dexcom.

Yes, my CGM supplies are Dexcom, not Medtronic.

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