I’m so frustrated! After getting switch to Edwards Health last month…I call them to make sure his 2nd shipment is on track only to be told they are no longer in our network. Call the insurance company and they say that Edwards is in network but only Edgepark is the preferred provider.
Insurance say we can still go through Edwards but we need a PA. Edwards says they were specifically told that if they don’t already have a PA on file that they can no longer provide his supplies. They say no new PA will be accepted my the insurance company.
We only have a PA on his Dexcom supplies. Pump supplies never required a PA. They are basically forcing us back to Edgepark with no warning. Either way, we won’t be getting supplies this month.
Have you tried switching to Byram? I started searching the market when I was denied supplies by Edgepark and they have been wonderful. I’m not sure if they will cover what you need but I get all of my dexcom sensors from them.
It seems like Edgepark is making deals to make themselves the sole network supplier for people. If you are in NC and have BCBS, even if it is an out of state plan like mine, you will be using BCBS of NC’s network and Edgepark is the sole network supplier for insulin pumps, CGMs, and related supplies. I imagine Edgepark is working towards that in other states and with other insurer’s as well.
Got the call today that BC/BS finally approved my Dexcom and are moving forward with fulfilling the request…BUT… Dexcom sent me to Edgepark for the actual order because they are “In Network” in New York State. I told the rep from Dexcom about all of these horror stories I have read and he said, and I quote " I know that this is not the ideal situation for you and I hope you will at least give them a try. I am a diabetic and have been forced to use them as well and I read all of the forums about Edgepark. I am really sorry, and if you have any issues, I will help you to get to another brand." HOW can Dexcom freely admit that their product is being distributed by a company that so many people have serious issues with? I want to get my T1 back under control - not to have to deal with delayed shipments, wrong shipments, and no access to the supplier for support. I told the rep from Dexcom that I would give them ONE chance to get it right. I am really hoping that I will have a positive experience, but the entire world, minus a few positive posts seems to agree that Edgepark just does not live up to expectations. Please wish me luck. I will report back with results as soon as I have them. I was told I would hear from the local Edgepark rep by next week on Thursday or Friday.
I appreciate seeing this topic. I’d asked on another board about what supplier was recommended for Medicare Freestyle Libre supplies, as I wasn’t familiar with any of those listed as approved. This thread gives me some definite ideas of which one to avoid, as well as a couple of positive possibilities.
Sounds like you are in a similar boat as me. I really don’t blame Dexcom much for that particular issue, as if they refused to sell through Edgepark the insurance companies would just say “OK well that’s too bad, guess you won’t be covered under our plans then”. Not that Dexcom or any of the other companies are completely innocent…like how insanely expensive sensors are. But then again, a large reason they are so expensive is how much it costs just to get something approved to sell…but that is diverging into a completely different topic and issues.
It really is quite ridiculous that we are forced to have no choice with our care.
Have to be honest here - I am pretty shocked. The app went over to EP last Friday afternoon, and I already have been contacted by the rep there letting me know she would be calling me tomorrow after getting all of my costs and plan details together. Not a bad first step - hopefully this will continue to be good!
I actually put a grievance in with our insurance company. They called me back on Saturday and I explained the entire situation. This morning I got a call from my Edgepark rep. I was prepared for bad news but she said she got an email from her superior with instructions to ship my son’s order today. Yay! Hopefully this continues. Maybe they put a note in my son’s account about his crazy mom.
Got the email from my EP rep tonight - APPROVED!!! She fought with BC/BS and got me my Dexcom! It is being shipped out tomorrow and I will finally have it. Edgepark, at least in my case was absolutely GREAT in every way. My rep was responsive in a timely manner, called me to give me status updates, and emailed me almost daily to make sure I knew where I was in the approval process. I just cannot find any fault here (again, in my case) and I am as happy as I can be. I cannot wait to get my CGM and get back in control!
