So after a few months of dealing with Dexcom telling me it’s my Insurance/CareCentrix for the reason of only being allowed to order 1mo supply at a time instead of 3mo at a time, finally found the true reason. Wasn’t Cigna and it wasn’t directly CareCentrix, however, it’s from a change Care Centrix made. They used to use “A” codes for most open market insurance companies. They made the switch to use “K” codes which is used by Medicare. Simple enough. However, Dexcom currently has it hard-coded in their system that these “K” codes can ONLY be ordered 1mo supply at a time. This is to prevent someone from shipping out more than 1 mo and Dexcom having to eat the cost. So it’s not our insurance or CareCentrix but Dexcom’s (current) system. Supposedly they’re working on a method to allow a workaround but I guess that’s been said internally for a while.
Do you know source of who defines the meaning of the codes? Is code K intended for Medicare only? Why did your plan change from A to K?
I explained the change in my original post. My plan did not change. It was a “decision” by someone or a group at CareCentrix to change from the “A” to the “K” codes. To my knowledge who makes them up is more of an industry thing for the “A” and the “K” is made up I’m sure by the bureaucracy in DC and yes they’re essentially used exclusively for Medicare products, procedures, etc. Those are not definitive, just a best guess as these are detail quetions that one would have to spend their own time to research, confirm/correct, etc.
Hi @Eric30, I went through a similar ordeal recently.
I also use Carecentrix and Dexcom. In my conversations with all the players, it seemed that several insurance companies that contract with Carecentrix now limit the supply to 30 days. My insurance company doesn’t, so there was no reason I should have this limitation put upon me.
Until Dexcom fixes their system, it seemed that I was stuck with the 30 day order (K codes). I don’t mind the shipments occurring every 30 days, but I’m not going to go through the authorization bs every 30 days.
I was able to get my insurance to authorize a year of supplies with the shipments occurring every 30 days. I often restart my G6 sensors and can get them to last past the 10 days, so I can build up a stash in order to maintain at least a 90 day supply. I just have to deal with fewer sensors/shipment and shipments every 30 days. I can deal with that. Maybe they’ll have it fixed by early next year when I need a new authorization.
Hopefully that helps you a little bit.
Also, it seems that Dexcom has went “mainstream” so to speak and now go through pharmacy’s (Walgreen’s for sure and have them in-stock but you can only do 30 days worth, CVS might be up-to-speed in another ~3 weeks and they, with a little fighting with help from your doctor, are able to do 90-days worth but they might push you towards 30-day as it’s more beneficial to them. Other pharmacies are also able but did not inquire at the time I was learning this.
@Eric30 I had the same problem. Dexcom suggested I switch from Carecentrix to Solera which still ships a 90 day supply. I did this and so far they are indeed shipping Dexcom 90 day supply.
Not sure if it’s related but I’m getting mine from a pharmacy (Walgreens), and after upgrading to G6 I’m now limited to a 60 day order (two boxes of 3 ea.)
I just started getting mine from Express Scripts. No problem with a 90-day supply and the product was shipped two days after they received the script.