How to get an Insulin Pump/CGM for mom?

Hi everyone,

Mom’s endo doesn’t want to write an RX for her to get a pump. Her Endo said my mom doesn’t seem to be a serious case and that we would not be able to afford one. Heh, let’s just say that I actually will be able to afford one along with the additional equipment/ sensors etc and I made that very clear to her Endo. Talk about jack*** of the month, huh? Forget the Insulin Pump, he doesn’t even want to write her an RX for the CGM either! He said the paperwork will not be " worth it". I just ended up hanging up on him.

I suggest you have an appointment with the doctor and review details on how it is working now, what’s not working well, and how using a pump and cgm would improve things for your mom.
If insurance is going to be involved with covering the pump and supplies, the doctors (or their staff), do spend considerable time working with the pump companies and insurance companies to get approvals. Often representatives from the pump company (Medtronic, Animas, Tandem, etc), can also do a lot of the legwork.
So if you have a specific company in mind, you may want to start with contacting them, and your doctor might be willing once they are providing much of the paperwork.

But ultimately a physician needs to provide the Rx, so you may need to find a new physician that would support it.

I had much better success getting my pump and cgm by having the company (Tandem/Dexcom) do all the paperwork. They coordinated with insurance, figured out my benefits, drafted the letter of medical necessity and sent pre-filled forms to my doctor. All she had to do was sign it.

You still need cooperation from your doctor. And the problem faced by an endo is that a patient on a pump/CGM may take more work than one on MDI. There is a significant start up learning to use a pump. My personal belief is that a patient should have demonstrated command of an MDI regime before moving to a pump. Just having lots of things to adjust doesn’t mean you know how to adjust them. And a pump is not automagical. If you don’t learn to use the pump on your own then you will be a resource burden on your endo.

So let me ask, is your mother counting her carbs and making mealtime insulin dosing decisions on her own? Does she test 4-6 times a day herself? Does she calculate insulin doses and take corrections based on being high? Does she consistently remember to test and take insulin herself? If she is not doing things then she may not be a good candidate for a pump.