Insurance plan no longer covering my Dexcom

Hey everybody,

I have a question about a problem that I haven’t encountered before and am hoping someone has experience dealing with it.

My insurance company has ended their relationship with Dexcom. I don’t believe that a letter of medical necessity is going to help me in this case. Any ideas besides paying out of pocket?

I still it just that you can’t get it from Dexcom and need to use a supply house? My insurance wouldn’t let me order through Dexcom, I had to go through Diabetes Center of the Midlands. My benefits just changed, so my process is different now.

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I agree with Jean, that it may be just that your insurance won’t accept claims from Dexcom. My insurance has never accepted direct claims from Dexcom, and I currently use Byram mail order. Byram does the correspondence with my dr to get RX and prior auth, then bills my insurance and ships out the product.
Check your insurance plan / website to see if they have list of approved DME suppliers (durable medical equipment), or call and ask them how to obtain such a list.

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Call Dexcom directly and tell them you need them to determine your insurance eligibility. They’re the one with the financial interest in making that determination — it’s their job… they told me everything I needed to know about how to source it through a supplier that my insurance worked with

Your insurance has no interest in helping you figure this out. Dexcom does…

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I would be very surprised if any insurance company outright excluded Dexcom as a CGM manufacturer. What has more likely occurred is that your supplies for the Dexcom (Rcvr, Xmtr and sensors) come from a DME suppliers and that Dexcom is no longer one of the approved DME suppliers for your insurance. You probably just need to find out who is now the approved DME supplier (like Byram or Edgepark).

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I agree with everyone else, you probably just can’t order straight from Dexcom anymore. If you call, they will find out who you need to order from. I also order from Byram, and my insurance considers the Dexcom a pharmacy product, not DME.

At the risk of sounding like a broken record… Earlier this year, I received a letter telling me that my insurance company ended their agreement with Animas – what it meant was that I needed to get my supplies from another supplier, not directly from Animas. This didn’t affect me, since I was already doing that; however, it highlights the concept. Like others, I never have been able to get Descom supplies directly from Dexcom under my current insurance. It has made getting supplies slightly more complicated – Dexcom’s supply system was terrific when I used them – but it hasn’t resulted in any disruption of coverage.

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You guys are right. They called me back today and said that they are changing distributors. No effects on me. They said they have gotten lots of panicked calls. All is well.

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