HMO discontinued coverage of my CGMS ;o(

I received a call today informing me that my HMO (Harvard Pilgrim Health Care) has decided to discontinue coverage of the CGMS. I am so sad. My A1c at the start of my CGMS use was 7.4%. Within 90 days of CGMS use, I dropped to a 6.7%. I am so sad that they will not cover it anymore as I cannot afford to be on it without their assistance. At $30 per sensor I will be paying just under $90 per week to continue using this. I cannot keep the sensor on the 6-7 days that some users are able to due to sensitive skin irritation that I encounter if I push use beyond the 3-day mark. I will have to give this wonderful device up once they discontinue coverage…date TBA. If you have Harvard Pilgrim, please help me to fight this! Call and voice your opinion 1-888-333-4742. They need to understand that they will ultimately pay more money covering our medical bills due to diabetes-related complications (that this wonderful device can surely help to prevent) than they will for paying for this device upfront. I feel defeated; I was so very happy with my health plan and everything Harvard Pilgrim was doing to help me improve my health. Now, I feel that they have given up the fight.

I had a meeting with the Minimed rep yesterday about the CGM - the sensors in Australia are $72.50 (AUD) each. These are also not covered under any medical insurance over here.

I was also informed that the sensors you use in the States are different from the approved sensors we are able to use over here. I have relatives in the States that I was going to get to purchase them for me because the exchange rate is so good. There goes that idea.

It seems that health insurance is the same everywhere!!!

Have you appealed? Aetna is a pain in the butt too…but i sent in a lengthy appeal, 15 pages along with pre and post A1C’s and a big plea about ‘who will give me a kidney when i need one’–they approved it

Aetna Approves CGM Coverage—check out my post from yesterday under the Main forums—i have my sappy letter, and an excel spreadsheet of my sucky pre-Dexcom meter reads (3+ months worth) in that post…feel free to plagerize. I also have letters from my Endo (not attached) but would be happy to send them separately…i typed them all out for my Endo, and she signed and faxed them back to me—i didnt post these but will email them if you want. Dexcom gave me the basic form letters and i just personalized them.

MM tape bugged my skin too…Dexcom does not—it looks just the same but i guess it is not…BUT i still use the shower covers on my Dexcom, because when the adhesive gets wet, it starts to peel and irritate. I know several MM CGM users that use the Dexcom shower covers (they are 10 for $6)- they cover the entire sensor and transmitter and hold that pesky MM transmitter down–and this helps them use the MM for 6+ days-- you may want to try one… if you send me your address i can mail you one—they are sticky and i can use mine 10 days in a row, stick it and leave it—(Dex transmitter does not have to be recharged)

Good luck.

I was reading another blog on diatribe—regarding an appeal to Harvard Pilgrim–you may want to check this out—it doesnt have a posted date but you might be able to hook up with the author and get more scoop. Good luck to you.

Thank you so much! You are a great help!