Hello Everyone–tomorrow I finish my week long trial of the Dexcom. I will try to obtain one through my insurance which is Highmark Blue Cross/Blue Shield. My doctor has requested I get one due to frequent hypo unawareness. Does anyone have my insurance and did they cover the Dexcom?
I would suggest calling your insurance company and inquire what your specific plan allows/covers. BCBS I had (different than Highmark) did, but not all BCBS are the same. With an MD order and note of medical necessity it should be covered depending on your plan however. If most of your other DM supplies are covered you are probably good. Coming from somone working in the healthcare field as well as having DM, know your plan inside and out and get as educated as you can about what it covers. Even if someone else has Highmark, you may have designated personal difference within your plan. Its a juggle. They should be able to tell you. Good luck kj
I have Anthem Blue Cross and just got approved 3 weeks ago. It may be different for you, but my insurance required 4 or more lows below 50mg/dl in a 30 day period. They also request that you be testing at least 4 times a day, so make sure you’re testing frequently. Or your A1Cs have to be >8 or something like that. Anyhow, that was my experience, though Anthem may be different than Highmark.
Thanks for the advice. It’s greatly appreciated!
If the requirements for Highmark are the same, I should be good. Thanks for the heads up!
I don’t have Highmark, but I have Anthem BC/BS, and I basically needed my doctor to say that I needed it for stuff like hypo unawareness and because we (eventually) are planning on having kids. They covered it at 80/20 (they pay 80%, I paid 20%) , and I believe it is covered under my durable medical equipment benefit, so you might want to check to see what that is going to be for your plan. I’d also check to see what your deductible and out of pocket max is to help you decide if you can afford it, because even if they cover it, you might end up having to pay a ton for sensors and stuff like that if you have a high deductible or high out of pocket max. Does that make sense? Hopefully I’m not just rambling . . . Good luck, I hope your insurance covers it, it has really helped me a lot!
I have Anthem BC and I am covered 100%. I have to stop seeing my endo and switch back to my primary doc, when the former (some very old guy, who would not even use a laptop but goes around with mountain of papers). MY primary doc is an asian guy who i relate to very well. He did all the paperwork and in few weeks I got the 1st shipment. Left to my endo, I would not have tasted this wonderful technology
Thanks Guys! I found out today that I am covered 100% and I will probably receive the Dexcom in a 7-10 days!
Who is your primary? Looking for one. kj
… i live a world away from you here in CA.
His name is dr Ghadia- an Indian gentleman