I have had diabetes for about 14 years. Failed 3 different pills, now on MDI. I take about 5-6 shots a day give or take. I use lantus and novolog.
I test 8-10 times a day. I am relatively well controlled with an A1c of 5.9. I do not see an endocrinologist-just a GP and we seem to do fine together. So far I have little to no complications-except numbness in my feet which may be due to a back injury, not my diabetes. I think I would do well with a pump, but I am worried the insurance will say no since I do well on MDI. Do you have to be "sicker" or "less well controlled" or have complications to qualify for a pump? I know all insurances are different, but in general, what are peoples experiences getting qualified for a pump? How do you figure out which one is right for you, if your insurance gives you a choice of pumps? I did contact Omnipod and wore their fake/trial pump and I don't think it's for me-I kept banging it on things. I think I would do better with one with tubing. Thanks for your help!
I got to pick which pump I wanted. I like my Medtronic pump. It will all depend on your insurance company as to if and how much they will pay for it. It is worth the fight. I did the pills, I did the shots and I have been on a pump for 4 years and I would not go back.
I’m an Omni pumper, I had to get in better control to get my pump. I had to show I could manage it. So I had to turn in 3 months of full logs. My endo and pump rep did everything for me with insurance.
Hi…former OmniPodder and current t:slim pumper. I believe that I originally had to show logs, as well. When I switched to the t:slim, they handled the insurance situation and contacted my endo. I’m pretty sure that rep will walk you through the process, although most of the “work” is theirs.
Thanks for all the replies- I have logbooks with the last several months in them, and I use the freestyle insulinx meter, so I could also just print them off which on that meter also includes my insulin doses-boluses and long acting. By noon today-3 shots-I'm sure there will be 3-4 more at least today. I think pumping with be much better for me- My insurance said I need a pre authorization, but it would be covered 90%. I see the Dr on the 11th, so I will be talking to her about it then. Thanks for all the help!
I have that meter…doesn’t include insulin dosages, which is why I requested it in the first place. Perhaps mine is defective. Been a crazy busy year; but, I thought the manufacturer told me that the “insulin” option was only available outside the US.
You have to hook it up to your computer to set up the insulin logging feature-it will not calculate a dose like it does outside the US though-only log what you took. You can only manually log your doses of rapid or long acting insulin-I do like it though. You can buy the ones from overseas on e bay though that will- there are instructions all over the internet on how to program them. It will only give you your blood sugars in the system they use across the pond though.
Thanks. I had trouble seeing the screen; I think that’s why I didn’t pursue my “problem”.
KrabbyKelly,
The description of your situation is identical to what mine was (literally). My doc filled out the pump paperwork (provided by the company and the DME supplier) and we were very surprised when we had approval from my primary and secondary insurance in two weeks. It came down to the number of daily shots required to keep control of my diabetes and the fact that despite the good control I still had a heck of a case of dawn phenomenon.
With those two facts the pump was shipping to me the same day I found out it was approved.
As to what pump, I picked out my pump myself before all of this started; however, with my insurance company they really didn't care which pump I chose. The issue with them was rather the DME supplier was in-network or not. Roche found an in-network provider and that is who I am using. This provider actually provides something like four different brands of pumps so anyone of those four pumps would have been acceptable to my insurance company.
Mike
Thanks! I had my appointment with my regular doctor who referred me to an endocrinologist(finally), and did thyroid blood work thinking I may also have Hashimoto's thyroiditis. So I am keeping my fingers crossed that I get in soon-waiting for the call back, and that they will agree I could use a pump and get the ball rolling! I am going to go back through the 3 meters I use and fill in a log book the best I can in case I need that-not a fun process! I guess I should keep better records! I use the Freestyle Insulinx as my main meter, so at least 99% of my insulin doses are logged on there.
I see an Endocrinologist. When I asked about pumping the doctor's office wrote the script and contacted Medtronic for me. By the time I got home that day the phone rang and some one from Minimed called to take the insurance info. I had the pump in about a week. I am now out of warranty since two weeks ago, so I am in the process of getting a new pump. It depends on the insurance company. BCBS rules are less stringent. You only need the doctor to write the letter of necessity and you have the logbooks. It shouldn't be that much of a problem.