HI all, I have for 13 years had issues with ups and downs with my sugars, I am type 1, my doctor will not give me a pump as he is the only one on call. hmmm. so I take 6+ needles a day and at least that testing my sugars. I am wondering if one can purchase a CGM on there own and use it? I live in Canada and only have one diabetes specialist in town, am looking into one out of town but the doctors seem to not want to step on anyone's toes. I am just trying to better manage my diabetes but seems it is hanging on what doctors or educators say and not what I would like.
also if my insurance would pay for it would I then need a prescription. is this tool worth the fight?
That's difficult to answer for members in the US, as our medical culture is a little different than from Canada, but for me, the CGM is indispensable, as is the pump. Insurance would probably require a prescription, as well as a letter of medical necessity, from your doctor.
You can call Minimed (or any other CGM vendor) directly for information, as they should be very familiar with the process for your country. 1-800-MINIMED.
Sure do need a prescription for pumps even in canada.. Id try calling one of the pump manufacturers.. A lot of physicians in canada do not like to prescribe pumps because it costs the particular province money.. Unfortunately its canadian version of the healthcare game.. Might want to talk to some of the members of the diabetes online community that are in canada.. Wish I knew of a particular canadian to help you out.
Love to hear how it goes.. your going to have to fight, and I found it was worth it (in the states)...
If you live in a province thay pays for the pump, it is not an issue with the doctor not wanting to write a prescription due to the cost to OHIP, it is a matter of qualifying for the pump. You must do this to make sure you know how to use it and you will be safe.
I live in Ontario and the cost of the pump, which is gather is $7,000, is covered by OHIP as well as an annual payment of $2,400 per year to put towards my pump supplies. Therefore, private insurance companies will not pay for the pump or pump supplies. They do however, still cover insulin, strips, needles, etc.
To qualify for the pump I had to find an endo who was on the pump program and attend sessions with the endo, a dietition, a diabetic nurse and an information session on the pump. When they were confident that I had everything under control, I was recommended for a pump. I was monitored for one year and then received my pump.
When I received my pump I was required to attend classes to make sure I was able to operate it safely. That was two years ago, I am now monitored by the Endo twice a year to make sure that I am using the pump correctly and my BG is under control. I need to do this to keep receiving my annual payment from OHIP. If you pay for the pump on your own, I'm not sure how you would do this. I also live in a small town and I travel to a larger centre to the clinic. I found my endo by calling the rep from Medtronics to ask who was on the program because I was given the run around by the local endo. Not all doctors have the knowledge,the staff nor the time to deal with a pump patient.
If the $7,000 up-front cost is an issue for Sarah's coverage, she could also look into the Insulet OmniPod solution. An estimate is $500 up-front (PDA) and annual expenses of $4,500 (pods and supplies). Please check with the distributor to very those numbers.
Joan may I ask what city you go to?
I have been looking for a specialist and willing to travel. It is not the cost but the specialist does not want to add another person since he is the only one on call. Was/is even willing to stay in a centre to learn and be monitored. Fight it is thanks for all the advice.
I go to the Diabetes Clinic at St Joseph Hospital in London. There is more than one endo and a whole support team. They are associated with Western University. Your doctor is probably familiar with this clinic. You just need a referral from him or from your family doctor. Good luck!
