Let me start this post by saying I love my Dexcom, and have been a faithful wearer for a couple years now. I was thrilled last August when my insurance said they would cover the Seven Plus at 90/10, as I had been paying out of pocket for my first Dexcom for over a year. The first set of sensors were so much more accurate, and I got 14 days of life out of them.
The problem is that since that first order, I have never been able to get another order placed. There were many issues between my insurance and Dexcom, one being my insurance only paid at 80/20, after quoting a different number. My insurance finally went back and corrected that mistake, but said it was a one time only, and that everything after that would be at 80/20. After months of going back and forth, finally I thought I was going to be able to place an order (knowing that I was going to have a $500 deductible, and that there was no “in-network” for my state and insurance). This was on Feb. 22, the last time I have heard from customer service. I have been working with the same gal since November (the only person who would return my calls beginning in Oct., when I tried to place the first sensor order), but now she won’t return my calls. She took my credit card information, told me my total, but had to check with insurance on something and would get back to me. I assumed she meant a couple days, but it is now March 28th, and I have heard nothing, despite me leaving five phone messages (I am polite, but to the point about wanting to hear back from her). In the past two weeks I have emailed two different people with Dexcom, but have not heard back from them either. One was to my local sales rep., and the other was to the Regional Sales Director, whom helped me back in the Fall when I originally was trying to get someone to return my calls.
I just can’t believe it has been seven months since I got my new Dexcom, and have yet to place an order. From late Sept. to the end of Dec., Dex actually sent me eight sensors, which I was very happy about, and I at least felt they were trying to be helpful at the time. I never asked for the free ones, but now I would just be happy with a returned phone call! Anyone else have any long-term issues with Dexcom? Any suggestions out there?
I don’t think this is a DexCom issue. DexCom does not spend time fencing with insurance companies. I think the insurance company is telling you they will pay for the sensors and either telling DexCom they won’t or they won’t pay their portion at the price DexCom wants. If you get out your credit card and place the order today with DexCom, you will have your sensors in three days unless you want to pay for overnight shipping. Then you can have your sensors tomorrow. It’s not DexCom’s obligation to make the insurance company pay. You are the insured not DexCom. If your insurance is through your place of business see your human resources manager. Maybe they will go to bat for you with the insurance company. On the other hand, maybe someone erred in telling you they would pay for the sensors and found out they made a mistake. In any case, you need to clear up the insurance coverage issue. If you pay for the sensors directly can you submit the bills to the insurance company?
When I got my Dex they quoted me at 80/20 because they weren’t a network pharmacy. I actually had to find a network pharmacy and have Dex contact them to get my supplies covered at the 100% my insurance claims they are covered at. Fortunately I already worked with a mail order pharmacy for my Omnipod so this wasn’t a problem for me. Dex doesn’t seem to be very knowledgeable or communicative with insurance companies but if you do the work you can get things covered properly.
Dexcom told me there is no network pharmacy for Washington State. If anyone knows differently, I would love to know of one.
The frustration is with Dexcom, because I have left five messages since Feb. 22, when I did give her my credit card number, and have heard nothing back. I have to chuckle when I leave the message, because her voice message states “I will return your call within 1-2 working days.” Perhaps she meant working months??? In my voice messages I always asked for a return call to “please call and let me know where my order stands.” The last issue was the outstanding bill from the original order, and I told her that I had the corrected EOB in my hand from my insurance company, and that I owed something like $25, but she said needed to speak with the insurance department at Dex to verify.
On a side note…today is a vacation day for me, but I am only up at this time because my blood sugar dropped to 42! Sure wish I was wearing Louise (as in my pump is Thelma, the Dex Louise)!
I know mine is mail order. I would contact your insurance company and ask them if there are any mail order pharmacies that they consider in network.
I feel your misery; we had issues getting my husband his Dexcom. If it were me I would call as if I were purchasing a system - that way you could get some guidance as to who to speak with - they do have a dept that deals with insurance companies, however; most of us have to puchase it from a distributor such as Liberty. We were so frustated we purchased everything ourselves - our insurance denied the request for six months; however through presistance and the help of our doctor and our local Dexcom representative we were reimbursed. Our Dexcom is our life line to something close to a normal life - it’s not prefect and neither is the system providing it. Get a supervisor, keep calling don’t give up - because there are people at Dexcom that care and will follow up I have found them and worked with them - good luck.
I have had exactly the opposite experience. My insurance approved me for CGM in two hours and has paid 100% both for the initial order and for my two reorders. My only issue is very minor compared to yours. I have to wait until the last week before I can reorder, unlike my mail away pharmacy where I can reorder four weeks before my supply runs out.
I second AaronM’s suggestion to contact your HR department if your insurance is through your employer. Your employer is the insurer’s customer and the insurer should be motivated to keep your employer happy.
Good luck getting this mess straightened out.
Here’s an update on the situation…
Yesterday I had my appointment with my endocrinologist and I filled him in on my frustrations with Dexcom. It still has been since Feb. 22 since I have spoken with anyone from there. My doctor’s comment was “I don’t know who is more mad, you or I, but I assure you, you will have sensors by this time next week!” Now that’s what I’m talking about:) I love that I have a doctor who goes to bat for me! He told me that he is friends with the president of Dexcom and will contact them if necessary.
Well low and behold, on a Saturday morning, I received a phone call from the Western director at Dexcom! First, he apologized for not returning my email that I sent back on March 19, and he told me that they would be sending me a free box of sensors. Second, he told me that Lori, the head of customer service, would be calling me on Monday to straighten things out.
I am hopeful this time, and especially appreciative of my doctor. I wish everyone had a doctor who advocates for them. Even better yet, I wish that things went more smoothly and I never even had to involve him at all.
Another update…As promised, the head of customer service, Laurie, called me Monday morning. She sent me out a free box of sensors, which I received Tuesday morning, and told me that from here on out, she is handling my order. She had already contacted my insurance, and it seems I may actually get my sensors at 90/10 after all, so that would be great. She also told me that the last person who was handling my situation had not logged in any of our conversations since December, which was crazy, because we had spoken several times with the last date being on Feb. 22. I don’t know what is happening with that employee, but I got the feeling that Dexcom wasn’t very happy with her. I Laurie back when I start my third sensor, and she thought she would have everything worked out by then. Hope this is the end of my troubles!
Good for you Toni! I’m so glad you pursued it and won. I’ve had great success with Dexcom and have no complaints about their service. Enjoy!