Happy New Year to all of you!
Hope we did (reasonably) well handling the holiday food fest.
As I continue to move forward in getting a Dexcom CGM, I am working thru the costs that I might expect with this,
setting up a budget plan to hopefully cover myself when the HRA/FSA runs dry.
Not having much success through the Dexcom site (where do you go to purchase supplies?).
I am guessing that supplies run similar to the cost of supplies for the Animas Pump. Would this be close?
Anyone have a guess-timate of what yearly or by re-order cost is? Before Insurance, as insurance varies greatly.
I priced this all out recently for my own FSA set up. I believe that the sensors cost $275/box, with one box theoretically lasting one month (4 sensors in a box). I believe that is the cash price, though they may do a bit of a discount if you set up for automatic reorder or you do a few months at a time.
DME deductibles, DME copays, and contract pricing between insurance company and Dexcom make estimating cost really complicated. Good news is there is no need to figure it out because Dexcom will contact your insurance company on your behalf (once you initiate the paperwork) and call you back with a complete breakdown of your bottom-line.
In my case on a prior insurance plan I had with a $250 deductible and 20% copay, my cost for the Dex system would have been $430 for the initial kit and then $55.86 for each box of 4 sensors (contract pricing). I never got as far as figuring out how to budget for ongoing transmitter and receiver replacements as I was financially unable to buy. You can ask the rep about stuff like that and anything else on your mind. The rep I had was very clear and well-informed.
Of course your yearly cost will also depend on whether you use sensors for 7 days or attempt to extend them.
What was billed to my insurance was around $404 a box, insurance approved them at $323 a box I pay 20% so about $65 a box. I get two plus weeks out of my sensors so that cuts the cost way down. Right now I am on day 24 with the same sensor!
Most people purchase straight through Dexcom but my insurance requires me to go through a third party, Edgepark medical. They are great always been very helpful, and persuasive with my insurance.
Congrats on pairing the Dex with your pump. The Dex has been a huge help to me.
Many Dexcom users are getting two weeks out of each sensor. Mine are lasting an average of two weeks. That would mean a box of four sensors would last two months. The accuracy for many of us is better during the second week, than during the first.
Yes, the sensors can add up but it is possible to get more than 5 days out of each. I’m starting to wonder about the transmitter, assuming I don’t lose it. That seems like a hidden cost that could be looming out there.
Does Dexcom have a policy on replacing it when the battery dies? I don’t have the Dex information in front of me now but I seem to remember that there was a 1-year warranty on it, and some people had posted here about difficulty replacing it. I hope it doesn’t come down to me trying to convince my insurance company that it should be covered.
My ins comp was billed 2,999 total for the receiver and 3 boxes of sensors. As I have state managed care medical (network) I go through neighborhood to get my supplies. I haven’t gotten my next set of sensors yet but once I do, I’ll get a better sense how much my ins comp was charged. I needed an authorization before beginning. Also I am not the lucky person to get more than 7 days out of a sensor. I did that and couldn’t wait to replace it with a newer one. Mine kept giving me the ??? constantly then sorting itself out. When it did work, it would be better results. So for me, I stick with changing it every 7 days.
I’m currently in that process… if there’s an issue within the 1st year, they will replace it. If you caused the issue from misuse, they will charge $300 for a new receiver. After 1 year, you can request a new one and resubmit to insurance, and hope they approve it.
If you learn all the tricks stated here in the Dexcom User’s Group, you can use each sensor for two week, on the average. I was also getting 5-7 days until I got that information here. This is info that you will not find in the manual. TuD has the best Dexcom group in the web.
I was buying sensors for cash, my insurance wouldn’t cover CGM but Edgepark found out I had medical insurance, even though mine didn’t cover CGM, so they raised my cash price substantially. Needles to say I won’t do business with them, and when I buy sensors with cash from other companies I have to lie and tell them I’m uninsured. Something’s wrong that I get penalized for being fortunate enough to even have access to some insurance even if inadequate.
Don’t give up Amy, there may be tips you have not seen yet. I dug back into the early discussions in February and found what I needed to know. That took me a lot of time, but it was worth the effort.
VEry helpful input- thanks to everyone.
I did call Dexcom re;costs and they referred me to Edgepark. They’re going to contact my insurance provider and research
my coverage/benefits. They’ll call me monday to go over estimated yearly costs. Nice.
About keeping those sensors in for 2 weeks- don’t they itch like crazy? They don’t get sore? I know if I leave my pump insert in 4 days, it gets sore. Guess I had better really read over all the tips and hints in previous discussions!
Maggie, I did get red spots until I started using Skin-Prep on my site before putting the tape on it. I have not had any problems since. Skin -Prep can be bought at drugstores, over the counter.
Maggie, the sensor is different from the pump, in that it doesn’t infuse anything into your body. I have never had a problem with my sensors irritating my skin. I leave my sensors in a minimum of 14 days; sometimes I restart it after 14 days and continue using it until I start getting the ???, I think I went three weeks once, but don’t push it anymore.
I have basically no insurance that will cover the Dexcom sensors. I am on Medicare and they do not recognize the Dexcom as being a ‘necessary’ part of Diabetic management. I originally got my first Dexcom through BCBS of IL. When my first year was up, I did not have that insurance anymore, so I had to pay out of pocket for the Dexcom receiver, transmitter and sensors. The receiver and transmitter were $300 each and the sensors were $350 for a box of 4 sensors. I am nearing the end of my sensors and I will probably have to stop using the Dexcom at that point. Since I also have hypo unawareness, it means I will probably need to give up driving as well. Getting old is h*** when it comes to getting supplies to manage my diabetes.
Mayumi, I also got my Dexcom from BCBS Il, through my husbands insurance plan. I now have my own insurance through BCBS Excellus NY, and the Il is secondary. I’m thinking of dropping the Il plan because it costs me $350 a month, and I’m thinking if the NY plan won’t cover them anymore, I’ll have to pay out of pocket., but it will still be cheaper than paying $350 month for insurance. Did you lose the BCBS before you went on Medicare? I have four years to go before I’ll be 65, am dreading having to go on Medicare and losing my Dexcom and OmniPod.
