Hi All,
I'm wondering if any of you have had success with getting a CGM covered in Ontario through any means possible. My work insurance (Green Shield) just denied our claim for it for our 9-year-old son ... who's had 3 seizures from lows which is why we purchased it. As you know, the ongoing costs are significant so any help you can provide would be greatly appreciated. Rachel
Hi All,
So I just went through the stress of being denied, so my benefits coordinator got involved and was amazing in getting this covered and adding it to our plan. That being said Great West has been horrible and still have not updated the wording on the policy… its been 3 weeks. I called and got a rude agent who insisted none of the plans covered CGM and I was mistaking a CGM for a Blood Glucose Meter, anyways supervisor came on the phone and said nothing was updated as yet and i wouldn’t be able to order it. GWL also will not do assignment of benefits like they do with my pump so I have to pay out of pocket and get reimbursed.
Happy its now covered, disappointed its taking so long and the fact I had to fight for something that helps make my life better.
Congratulations on finally getting it covered! I have Pacific Blue Cross and they’ve denied it for mea nd for everyone I know, even people who have appealed the decision. I’m part of a union, so I’m currently working with the union in getting them to ask for this to be a benefit, but I’m not holding my breath. PBC also apparently only covers one insulin pump per lifetime on my particular plan, which is ridiculous. So I’m currently paying out-of-pocket for my Dexcom (stretching each sensor as long as I can) and using a pump that’s more than a year out of warranty.
Hi Chris,
Wondering if you could elaborate on how you got coverage from GWL. My claim was rejected as GWL said policy covers pumps (with $ limit per time period), infusion sets and Blood glucose meters but no CGMs. I’ve applied twice (every plan year to see if coverage added) and been rejected twice. Could you reply here or PM me with some details of how you successfuly got coverage and also some details on your coverage (ie what is covered, what is your limit and under what category the claim is submitted against.
Thanks in advance
Tim
Messaged you
Hi Chris,
Could you please message me the details how you successfuly got coverage from GWL. I was rejected stating CGM’s are not in the policy.
Thank you in advance
Aman
Hi Invictus,
I had a same problem with GWL. My claim got rejected as GWL said CGMs are not covered.
I have send email to Chris to send me the details how successfully he got it covered.
Can you please email me the details Chris has send you. Just in case if he gets late in getting back to me.
Thank you
Aman
Hi Aman,
I had to get my employer to add it to coverage. I made the case it saved money in the long run with better control.
Sorry for the delay, I have been away.
Let me know if you need other info.
Chris