Posted about my basal quandary today. Conversation made me contact Dexcom.
I’m new to Medicare, but have BCBS as primary, Medicare Part A secondary, and Tri Care… why is a long story. Medicare approve the G5…wait for it…but not it’s use on a Smart device.
That’s the craziest thing I ever heard. Cause I’m 65, I can’t figure out how to work a Smart phone?
Sure there is a work around, but this is a bit offensive.
There’s actually another thread about this. A lot of us feel the same way, but it’s actually a little more complicated and not quite as stupid as it looks. It has to do with the statutory definition of “durable medical”: the only piece of the system that actually meets that standard is the receiver, so they have to make sure you’re actually using it. Kinda like people who get CPAP equipment: they actually have a way of checking that it’s actually being used, because they don’t want to pay for it if you’re getting it but never actually wearing the thing to bed. My view is that I use BOTH the receiver and phone app, a that fact is attested in my Clarity reports, so they shouldn’t care that I have the data on my phone as well as my receiver–I can demonstrate that I am in fact using the latter. Fortunately I’m not on Medicare yet, so I don’t have to make this argument, but it seems like forbidding you to use the app if you have and are using the receiver would be truly incomprehensible.
As well, this is not likely the end of the story.
Dexcom CEO has made it clear he does not like the policy either. However he wanted to get the orders shipping and being reimbursed before they start making any waves.
But yeah, a couple threads on these forums really go into the details. You would probably enjoy the read as long as it didn’t cause excessive aggravation for you.
One of our members, @Laddie, has written a blog post about this issue. She is new to Medicare this year and has used a CGM prior to her Medicare eligibility, so she has a vested interest in this policy. Her common sense take on things helps dissipate some of the emotions this new policy causes. Since Medicare is a large bureaucracy and this is a new policy, things are not settled and will surely change going forward.
Unfortunately Medicare must make rules to cover the least capable among us. The nanny state says they must treat us all as imbeciles.