Insurance Coverage for CGMS

I am looking for information from people who had to file an appeal with insurance to get them to pay for CGMS. I have a severe case of hypoglycemia unawareness the past couple of months and several call to the ems. I am getting my insulin pump on the 27th of this month.Any information would be helpful. I have BCBS of Texas.

Thank you


I am in the process of appealing now. I sent in my appeal, then we had a low emergency. I then added the EMS and ER reports to my appeal. Collect all the documentation you have to send in to them. I included color coded bg logs for the past 3 mos. Make sure the dr uses the dx code 250.83, it is the one specifically for t1d with uncontrolled hypoglycemia.

Thank you Jane, I really appreciate the information. I have been very frustrated with this process. I know i planned on including my ems reports with the information I’m submitting. Thank you.

We have several related discussions. Check out this one about someone’s coverage for the Medtronic sensor, this one about denial of coverage, this one on who has gotten coverage and from whom, and this one on how to appeal. Also, there is a petition you can sign demanding coverage for diabetics.