Regarding insulin pumps and CGM's, has anyone found one health insurance company to be better over another with regard to reimbursement and upgrades or replacements after several years. Thanks. Leslie
Leslie, I don't know if you got your question answered but I just saw your post.
I have maintained BCBS all my adult life and, in the second half of my life, primarily because of their support of my diabetes supplies. That includes pump and cgm.
I am on Medicare and, as you may know, it does not pay for cgm.
From what I understand, even BCBS will not pay secondary for cgm. It does for me, but only because I worked for the federal government the last several years of my career. Only the feds insurance, from what I know, pays for cgm after retirement. But, prior to retirement, you have to get your list of questions and contact the insurance companies of interest and see how they answer each one. Also, don't take their word for it, but check their online manuals.
I hope this helps.
My insurance is through BC-BS for state employees. I paid 20% of the cost out of pocket for my OmniPod PDM but nothing for the pods themselves as the pods are considered supplies (PDM is considered DME). I paid nothing out of pocket for my Dexcom CGM and I pay nothing for the sensors. (other than paying my insurance premiums)
I worry about retirement and wonder how retirees manage the cost of their diabetes care.
Smileandnod, you are correct. I don't know how non-gov retirees pay for cgm as none of the insurance companies will pay for it as a supplement because Medicare does not pay for it. I don't know why the ADA does not lobby for Medicare payment of cgm.
I am very lucky. The person who recruited me to the gov told me about the retirement insurance and that was a factor in my taking the job. With BCBS I never paid more than 10% for a pump or supplies. Now, I pay exhorbitant Medicare and BC fees but have no co-pay.
However, who knows what may happen to insurance in the near future if the public continues to be apathetic about pushing for better health care coverage. Versus protecting insurance companies. I have to be careful about not getting into politics here! Said too much already. If I need censoring, so be it.