Help needed

#1

I need info bad lol. I am hypoglycemic to the max my doctors want me on the Dexcom G6 my insurance refuses to cover it. I was going to pay for it out of pocket but can’t afford to does anyone have any suggestions

#2

If you are a member of Cisco or there’s one avaible they offer dexcom at great prices for pharmacy members, just don’t try to use insurance. And appeal your insurance denial.

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#3

Appeal it with your health insurance. My health insurance denied me an insulin pump twice. The third time I appealed it, with letters from my doctor, articles and stats it was approved by the 3rd party that reviews all appeals after the 3rd attempt. They approved it any my insurance was forced to give it to me.

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#4

Assume you meant Costco.
They had really low prices for G6 transmitter and receiver for the past several months, due to some rebates. I’ve heard the prices are higher now, but if interested, call to confirm. Sensors did not have rebate, and were about $325 for box of 3.

Not as good, but Libre may be covered, or available at lower cost in the interim.

If you have employer coverage, check with HR benefits to see if they can advise best way to appeal the decision. Its in their best interest to help you prevent other costly consequences of not having it.

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#5

Welcome to TuD Leah! And yes, Libre seems to be the best way to go if you have to pay out-of-pocket. Not as accurate as Dexcom but much better than relying solely on fingersticks for catching a hypo before it gets out of control. Also worth pushing the insurance on the G6 (or Libre for that matter). A lot of 'em say no as an initial response and hope you’ll just give up, even if you’re entitled to have one. Denying coverage is the only way for them to make money, ironically, since they claim to be part of the health providing system.

#6
  1. Are you currently on insulin?
  2. Are we to assume that you are not old enough to be on Medicare?
#7

Welcome Leah. Why are you so hypoglycemic? Are you taking too much insulin?

#9

Ask them if they cover the G5. Some insurance companies do not cover the G6 yet.

#10

I am not on insulin because I am hypoglycemic and no I’m not old enough for medicare

#11

They are not sure why I am like this yet I’m currently not on insulin

#12

I agree with drbb regarding the libre. Usually around 40 per sensor and the reader is around 90 but sometimes there are coupons. My old insurance said they cover the Dexcom, so the prior authorization forms are useless… they told me my company chose a new plan which excludes the Dexcom and last year it was included…at any rate, sounds like a good time to watch the rainmaker again.

#13

Most of the advice, you will find in this thread above. Additionally enjoy some pasta and really good pizza and see how that affects your hypoglycemia.

#14

When you say you are hypoglycemic to the max, how did you establish that? Are you measuring your blood sugar or just feel like you are hypoglycemic? If you have been measuring your blood sugar has that been before meals, 1 hour after meal, 2 hours after meal or all of those times? Were you measuring your breakfast, lunch or dinner meals? I am not looking for an argument or questioning your or your doctor’s assessment, just trying to get a better understanding to avoid sending you on a wild goose chase.

In the meantime wish you all the best and hope you can find some helpful suggestions in these posts.

#15

Exactly how low are your blood sugars? Are you measuring glucose levels with urine strips? Blood glucose? Or just estimating based on how you feel?