I have prior approval for my dexcom cgm kit however i have tried rite aid, cvs and walgreens and cant find any that are able to order it for me. I live in NYC Manhattan area. Any help will be appreciated.
Try Edgepark Medical Supplies. Your doctor needs to fax script and they should send device and continuing supplies every 3 months.
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I think it’s kind of a standard thing to get these kinds of supplies, which are “durable medical” (or associated with same in the case of sensors) rather than traditional pharmaceuticals, through a medical supply service. I’m currently using CVS’s Caremark system for sensors and insulin, but I’ve also used Better Living Now when I was getting Humalog cartridges, and Neighborhood Diabetes for pump supplies.
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As others have suggested, there is a different supply and distribution system for a lot of what is considered Durable Medical Equipment (DME). It is also true that many insurance plans have the equivalent of in-network suppliers for DME and you need to make sure you go to one of the approved providers. These suppliers may be just distributors but may also include original manufacturers. For instance my insurance Aenta has a list of their providers and what DME they provide.
Call Dexcom customer service, their phone number is on their website. Also you will order from them the starter kit and all the supplies
Foundation Care accepts most insurance and can bill through pharmacy benefits - it might be worth checking them out.
The vast majority of OTHER mail-order suppliers will only bill as DME - for someone with a substantial deductible, it’s MUCH more cost effective to order through pharmacy - this is how I normally order my dex and pump supplies… except for cartridges, since the $40 co-pay a month is WAY more than the insurance contracted rate through DME is (at $17 a box).
As others have mentioned, call Dexcom directly-- they will tell you who is the contracted supplier for your individual insurance plan. Typically they are provided through medical equipment suppliers instead of directly through your pharmacy. Once you know who is your contracted supplier you’ll order them directly through Dexcom, or such was the case with my supplier. It was really easy.
I’ve always got my Dexcom and pump supplies directly from the manufacturer. All of my insurances have been ok with this. Like someone said earlier, try them first.