I May Be Losing Coverage Of My Dexcom

I am not able to use my Dexcom now, for the past 6 weeks or so. I am in a MVP group (that is part of Medicare). Previously I had a NY State plan for my secondary insurance, and it covered my pump, Dexcom and all my supplies. Now the group has dropped the NY plan and adopted the MVP plan. I have to go with the group, I have no choice. It is my understanding that my pump will be covered, but the Dexcom will NOT be covered. I am hoarding my sensors and will use them only when I am taking a trip or vacation. That is when I will get the best use out of them.


I started using my Dexcom in January and I am concerned about the receiver and transmitter expiring and no longer being operable, if I try to use them many months from now. I cannot afford to pay for all the Dexcom expenses out of my own pocket.


I can afford to buy a few sensors each year, but the receiver and transmitter expenses each year is too much!

Richard, even if they say that your sensors won’t be covered, try to appeal that. I know everyone says that Medicare won’t pay for a CGMS, but I am on Medicare because of being on disability and I had a Navigator and now have a Dexcom. I have read more & more of the Medicare plans are paying for a CGMS.

Also, if they do say no, shop around for the best price on sensors. Some place will sell the receiver & transmitter separately, so if one breaks, you won’t necessarily have to buy them as a set, you can buy whatever breaks. I don’t know what Dexcom is selling sensors for cash price, but American Diabetes Wholesale has them at $332 a box.

I have had me System Seven about 14-1/2 months. The transmitter seems to be getting weaker. I have already received my replacement but have not started using it yet. I think I will start the next time I change sensors.

I wish you luck without Dexcom. I actually wish you luck in getting approved through secondary insurance. I am 56, so I am paying special attention to the posts about people on medicare losing their CGM and pump coverage.

It could be worse than just the pump & CGMS. Right now, although Medicare limits the number of strips, your doctor can override that and get you what you need. There is a proposal before Medicare to limit it to 6 a day regardless of what your doctor says you need or what ever problems you have.

Wow, Richard, I am sorry to hear that. I hope maybe Kelly is right, and you can get an appeal going! I am also on Medicare, due to disability, but all of my diabietes supplies are covered by my secondary (BC/BS). I truly hope you will find a way out of this problem! You deserve it, man! you have put up with Too much, Too long!

Kelly, I have had the test strip limitation with BC/BS when I was on MDI. They wanted to limit me to four a day. My doctor fought and fought them. Now, I don’t seem to be having a problem since I’m on the pump. My initial rx was for 8 times a day…now it’s for 10 times a day. We’ll see what they do with that. Once everything gets lined out with my pump settings and now the Dexcom, the doc will probably drop it back to 8 a day.

I am able to get more also. The way they have this new proposal worded, it won’t matter what your doctor wants, they won’t pay for any more than 6. Hopefully, that does not go thru. I will give up the pump if they limit me to 6.

Friends, thanks for your good wishes! Kelly I am allowed 1 strips per day, and they are covered. My next transmitter and receiver and sensors will apparently NOT be covered. I lived without a CGM for 64+ years, so I am not going to let this get me down. iIam a healthy old buzzard. Lol!

It is absolutely absurd how some insurance companies treat their members. The average person without a chronic illness has no idea what some of us go through. :-(… Richard, what boils me up is, they pay more for hospital visits, and unnecessary checkups, than test strips!! Huh??? The insurance companies are just plain old backwards, with a whole bunch of policies that don’t make any sense…

Thanks Yogirajj, I made a typo!!! I am allowed 10 strips per day

I was wondering when I saw the 1 strip and was hoping that was a typo!

Oh, thank God… I was so upset when I thought that was a 1… LOL… I was saying to myself “somebody @ the insurance office would have gotten smacked by me”… LOL…

Richard…do you still want some sensors? I have 2 unopened boxes. I am done with this thing. Its driving me crazy! The alarms go off constantly and I am often no where near the numbers it says.

Let me know

Lisa

I’ve noticed that myself. But I think that has more to do with the constant fluctuations of both blood sugars and hormones. My pump trainer told me that sometimes it also has to do with wear you put the sensor. It has only been approved for the abdomen. Also, if you sleep on the sensor, sometimes the blood spreads, resulting in an inaccurate reading. I’ve found that when I calibrate it once I get up in the morning, my numbers are more accurate throughout the day. You need to also calibrate when it’s memory has reset (after the 3 hour period. Lastly, remember that some medications can effect your readings as well.

good call yogiraj! I love your name…as one of my most cheristed teachers is named same.

Maybe i will revisit in a few days. Last night was the worst and I ripped it out this AM after only 3 days.

Jai!

Lisa, I have been saving sensors for several months now. I have all I need since I am going to use them only for traveling and holiday season purposes. Thanks so much for your offer! I’m sure there are other Tu members who need them more than I do.

In the past I’ve used sensors only on my abdomen, but recently decided to try my upper leg. I was quite surprised to find that I had accurate readings there.