Continuous Glucose Monitor

My endo surprised me and when she wrote the letter of necessity for the new pump, she did a letter of necessity for a CGM. I got a phone call from Dexcom and I thought it was just and advertising call. It was not until the person on the other end told me she had the letter of necessity in her hand that I realized it was true. I had figured that the insurance company had just paid $7000.00 for the pump I was not going to push it by asking for a CGM right away. I was approved and I love the CGM.

I would do everything I could to get the insurance company to pay for the CGM before I would go ahead and out of pocket it. I saw somewhere online that the transmitter and receiver is like $1200.00 and the monthly supplies are a little over $300.00. The transmitter and receiver are only warrantied for a year. That is if the insurance company pays for it.

Wow, you’re really jumping into this!!! If you pay out of pocket, you should just be able to ask your endo to write the script (Dex will ask for you, but you should let them know ahead of time). But try to get insurance coverage. It’s a decent chunk of change, more the monthly supplies than anything else. Some insurance companies have policies online, look for yours. Some require certain conditions (like readings <50, hypo-unawareness, A1c > X). If you have any low bgs that you don’t feel come on, report them to your endo so they can document it and get you some cgm!

I have also been looking into the Dexcom for my son. Endo wants us to wait until its intergated with the Omnipod he’s been using for 8 months now (We love it), not sure yet about our coverage. Started the BS log forms twice now, and sat on them because I was unsure. He’s only had a handful of <50 (dx 12/09) because he is very aware of going low, that shouldn’t be a strike. I am ready to get more information, though fortunately he would have to wear it. We need to troubleshoot his morning blood sugars pre and post meal. Dawn Phenomenom sometimes/ high after always. We made some changes, but a CGM would so helpful. Plus he will be driving in a year or so, nobody like to do all those checks. I think you should get it approved because you are home alone with the kids, for that alone! Ive used lil mama for a screenname before too. Lots of Luck.

Awesome! I have BCBS as well, let me know how it goes, good luck!

Glad you got what you needed with no hassle thats awesome! Trust me, I will do all I can to get the insurance to pay before I do out of pocket.

lol head first!! that’s how I roll!
I will def remember your tips, thanks Tom!

I would say go for the cgm, the more tools the better!!

I think my MM CGM was around $1000 and the sensors are about $30 each. My insurance pays. I did not have to prove hypos but I was pregnant when I got it.

According to my endo., being type 1 automatically qualifies you for CGM under BlueCross/BlueShield (my insurance). I didn’t have any problems with them covering the CGM.

My sensors, without insurance, are $42 each and last 3 days; so $420 a month. The CGM is integrated into my pump, so I don’t know the cost of it separately, but the pump + CGM was just north of $7K, paid by the insurance company. My out of pocket was about $200.

(I have the Medtronic Paradigm 523 with CGM).

Thats good to know, I have BCBS as well.I’m assuming the doctors label type 1.5 as simply type 1 for insurance purposes…right?

I think that since “officially” there is no type 1.5, LADA all gets lumped in with Type 1.



I think before you can ask your insurance to pay for it, you need a doctor/endo to say you need it. My process went like this:


  • Told the endocrinologist that I was ready for a pump with CGM. The doctor's office contacted Medtronic to get things started.
  • Medtronic contacted me for information to submit to the insurance company.
  • Once it was approved by insurance, Medtronic called me with an estimate of what was covered. After I agreed they shipped me the goods. They billed the insurance and whatever they didn't cover came to me as a bill about 2 months later.

I don’t know what health insurance you have but the rep from MM said they are usually approved for type 1 diabetics. I have Blue Cross a she said they are good about it. I am getting a new pump and decided to get a CGM too and I will probably wear it at night mostly. She also said I can upgrade when/if a new model comes out. Good luck