Dexcom Delays Medicare Coverage of G6


#102

I’m also concerned about the possibility that the G6 won’t works as well for me, as the G5. I’ve heard that it’s possible to switch back to the G5 but I’ve no idea if that is the actual truth of the matter (for Medicare users).


#103

You can still calibrate G6. You are not required, but nothing prevents you from doing so.


#104

Absolutely. You actually have three choices:

  • 100% Factory Calibration
  • 100% Manual Calibration
  • Start with Factory Calibration and add Manual Calibrations as desired

This is actually is a really nice approach they came up with in terms of choice for how to do calibrations with the Dexcom G6 cgm system.


#105

The insertion process may well be drastically different, but it’s not difficult to understand or to execute. My 7yo was diagnosed T1 on 8 Feb this year and got Dexcom G5 two weeks later. The diabetic educator showed how us to insert the sensor with a demo model, and 5 minutes later I helped my son push down on the plunger to insert his first sensor. The second and third sensors my wife or I just helped him stick the tape down, but he manages the insertion solo (I still had to help click the transmitter in afterwards). Yes, he’s very bright, sensible, and not needle phobic, but he’s still a 7 year old.
As for calibration, do a finger-stick when your BGLs are likely to be stable (i.e. before a meal), and enter the value in the Dexcom app…the only reason my son doesn’t do it solo is that he’s too busy doing something else (lego, minecraft, reading a book etc) so he needs to be hurried along!
I would think that for any adult who has been managing diabetes with MDI or pump for years (and can use a smartphone), Dexcom G5 really should be no big deal.


#106

That is interesting. What is the reason that as a new Dexcom user you started on the G5 instead of the G6?


#107

Welcome to TuDiabetes, @Dylan_Sutton! It’s great your 7-year old is blessed with a relaxed attitude about needles and poking himself. It’s just not natural for any human to stick themselves with something sharp. Many adults have problems with this. It sounds like your son is resilient and adaptable; these traits bode well in his treatment going forward. Diabetes is inherently a patient-treated disease.

There are many members here who are parents of T1D children. I hope you find this community as useful as I have.


#108

G6 isn’t available in Australia yet, that’s all:smile:


#109

when you google is Dexcom covered by medicare you get many hits from Dexcom, Glu, medicare and the list goes on and everyone of these organizations say the same thing it will be covered in early April. It sounds like nobody really knows what’s going on


#110

That is simply not true. Unfortunately a lot of articles, posts, etc. on the internet are not dated and therefore are outdated. Dexcom announced in early March 2019 that the date for Medicare patients to receive the G6 has been changed to Q4 2019. That is also what their Medicare page on their website shows.

"When will the G6 System be available to Medicare customers?

Dexcom will start shipping G6 to all Medicare customers in Q4 2019."

I have included the link here.
Dexcom March 2019 Medicare


#111

What CJ said. Be careful how you google. :slight_smile:


#112

FWIW, I am “old as dirt” and I feel I must use a cgm since I live alone and have severe low episodes that only a cgm alarm will alert me to, most of the time.

I tried the Medtronic and whoever designed it’s physical features and how it fits together and is separated is either a moron or a sadist.

I can do the Dex one-handed on the front of each upper arm, saving the abdominal area for pump. No pressure on the dex site ever, given its placement. I do not have any problems with insertion.

It is mostly accurate. I must do the finger sticks, yes.

It is standalone as I have the MM 630G pump and have 3 years to go before Medicare will pay for the Tx2 or whatever it is called. I might pay for the T pump if the Dex G6 inspired more confidence and was available. But now I see thee is a G7 in the works.

Now I am just wondering if I will live long enough to even think about the G7 or the T2x.

Those of you who have the years and the time to wait, if I were you, I would still be using the G5 instead of no cgm but I am not you so…
To me, close enough is good enough given the horrors I experienced with the MM version and I can’t think of not having a cgm 24/7.


#113

While that is stated on the Dexcom link you provided, I spoke with two different managers who both acknowledged that that is simply a placeholder, and is not an actual target to which the company is committed. Also, during the same conversations, they also admitted that Medicare had approved G6 coverage in October 2018, but Dexcom contractually prevented them from shipping the G6 because Dexcom’s manufacturing facility had repetitive random G6 production (and therefore shipping) delays that could likely leave Medicare G6 users without sensors for at least ten days.


#114

You can call it a placeholder or a committed target, it really makes no difference. The official stated Dexcom position at this time is that they will ship the G6 to Medicare patients Q4 of 2019. An intent or an official commitment is in no way a guarantee that the date will not actually be moved forward or back or even be totally changed due to G7 being ready before scheduled delivery and the G6 being skipped over. Machines break down, employees go on strike, factories burn down, unforeseen detrimental issues with current G6 and all sorts of events could happen to push back the G6 delivery to Medicare patients. It is in the best interest of Dexcom and patients to keep moving all patients to the latest best working hardware and software available they can deliver and properly service and that is what they have been doing.


#115

The point (that you’ve clearly missed) is that Dexcom’s public position is Medicare has not yet approved G6, but this was untrue: Medicare approved G6

Stuart


#116

…in October 2018. The reasons are not relevant; their dishonesty and nondisclosure (which may well be a NIPAA violation) is.

Your lengthy post is merely a general statement of possible explanation’s, and as such is irrelevant -unless your intention is only to defend Dexcom at all costs - and in any case, I stated their specific reasoning (as told directly to me) in my initial post.

In short, I am at a loss at finding a any uuyility in your post.

Stuart


#117

Can you point to any public position where Dexcom claims that Medicare has not yet approved G6 as of now?


#118

(1) Every Dexcom representative (tech support, billing, Medicare billing, sales) I’ve spoken with since October 2018 (the first expected Medicare G6 coverage date) has said the same thing - i.e., that Medicare has not yet approved G6 coverage…e.g., this page from October 18 2018, Dexcom states that “the new Dexcom G6® CGM System will be covered for Medicare beneficiaries…[Dexcom] expects to begin shipping product to Medicare customers in the first part of 2019.” Note the future tense (“will be covered”) when, as I was informed, it was already covered. The recent change to the end of 2019 is also motivated by G^ production and shipping delays - but my one and only point is that from the beginning Dexcom has never disclosed this as being the cause, relying on the above future tense to state the delays was Medicare’s doing until I persuaded them to do so, and that I consider this unethical and foolish: If Descom was concerned about reputation impact, they apparently didn’t consider said impact if the actual cause became common knowledge.
(2) DME suppliers: ditto
(3) Medicare: claimed no knowledge either way
(4) Internet: Dexcom has made no attempt to correct the incorrect information (i.e., Medicare is the source of the delay) resulting from a search
(5) Tandem representatives (tech representatives and supervisors, including a high-level supervisor who responsible for managing Dexcom establishing a presence in Canada and soon other countries)

In summary, my point is that I have high-level connections in both Dexcom and Tandem, and it took me months to reach an honest/courageous manager who confirmed what I was told previously by a DME supplier - again, even though G6 was approved in October 2017, Dexcom required a three-way contract (Dexcom, DME suppliers, and Medicare) to be signed that required providers and Medicare not to sell the G6 if the user’s insurance was Medicare and/or Medicaid - and to lock it down, Dexcom’s contract insisted that the Automatic Crossover between Medicare, Medigap, and Medicaid be prohibited.

If you remain recalcitrant, simply conduct a search for “why has the Dexcom G6 Medicare coverage continually delayed?” and you’ll not see any responses addressing the production/shipping delays.

Either way, I believe that I have made a sufficient case and do not plan to continue this discussion.


#119

You seem quite upset about something, but I’m not sure what your point is. When Dexcom begins selling the G6 for Medicare patients, that’s when it’s happening. The rest is just talk–who cares–you can’t buy something until it’s on the market. I say, hang tight. :slight_smile:


#120

I know you mean well and I therefore appreciate your post.

That said, my point is simple, so I’ll restate it concisely one last time: Dexcom decided NEVER to disclose that (1) Medicare already approved G6 coverage in October 2018; (2) promulgated an untrue cover story that the delay was due to Medicare NOT having yet approved the G6; and (3) to this day has neither corrected their posts (nor corrected other sources that published incorrect posts based on Dexcom’s cover story) while keeping secret the actual cause of the ongoing Medicare G6 coverage delay (i.e., production/shipping issues) without limiting higher-paying private insurance coverage.

I and every individual outside of TuD find this deceptive, dishonest and unethical, thereby creating a trust issue - the last thing that a manufacturer of life improving/sustaining DME should ever do.

In short, I do not take Dexcom to task for having the manufacturing issues mentioned - but I absolutely do so for being dishonest and manipulative.

If you still disagree with the above, there’s nothing more I can or will say.

Stuart


#121

To give you a little background…Before a product is actually made available to the public the manufacturer starts production and builds up a “stock pile.” That is because they are required to have on hand to supply the people using their product and maintain that supply (in other words, try to eliminate potential for “back orders”).

To a small extent this is a guessing game. You are guessing how many people will be on your product so you are projecting what will be needed to be able to maintain a consistent supply.

With companies like DexCom, who have earlier versions that are still in use by people, not only do they have to be making their stockpile of the new version (in this case G6) but they also have to maintain a consistent level of supply for the old version since people are still on it. That means that can’t devote all of their production to stock piling; production has to be allocated to making the supplies for the new product as well as maintain supplies needed for the old product.

You can’t just simply increase production either. The site were a product is being made must be inspected by the FDA. The sites that FDA approves to manufacturer a product are the ONLY sites that particular product can be made without going back to the FDA and going through the process again.

For Example, say Humalog (or Novolog) was made at a facility in New York. The company also has manufacturing plant in Dallas, Denver, and San Francisco. Denver is the only other site that has been approved by the FDA to make insulin. Say the place in New York had some issues with flooding and had to shut down manufacturing while they cleaned up the mess. Now only Denver is making insulin. Dallas and San Francisco cannot step in and help Denver with production because those two sites haven’t been authorized to make it.

Same could be true with DexCom, only so many plants have been approved to manufacturer the product so they can’t just increase production at another plant without going through the process of getting that plant approved to do so.

If DexCom did release the pump before they had enough supplies to be able to support demand without interruption people would be just as angry if not more so.

Oops…This wasn’t a replay to @toniobiko. I don’t know why it posted that way and I don’t know how do undo it as “a reply”.