Are there any Type 2 diabetic that have got a pump with their insurance. I have a c-peptide of 6.8 and A1C of 6.5 they refused to pay for the pump.
But I am very insulin resistance and can’t take pills for other reasons. I think they should take those thing into account. Yes I was denied.
Congrats on the A1c of 6.5!!! That’s great!!
I guess that you will have a hard time convincing them to pay for a pump, as a pump does not address insulin resistance any more than injected insulin does.
I was also initially rejected by my insurance company (a few years ago) and had to appeal the decision. I am a type 1 with a c-peptide close to zero. The point that my doctor used to appeal was that I was having lows at night.
I think that the insurance company see the pump as a way to avoid lows…
Sorry that I don’t have any better recommendation for you. I know that there are many different types of treatments for insulin resistance. Are you sure that none of them will help you? Do you see an endocrinologist? (They usually know more about the options than primary care physician.) Have you ever tried Byetta? I know this helped many.
I was on Byetta for about 2 years It was great stuff but my A!C’s were in the 9.0 range and we (endo And ME) could not get it down. We have tried everything The Endo can come up with and insulin is the only answer to keep in a good A!C. We are still going to FIGHT the insurance Co.
I am T2 starting insulin in August 2007 and got pump in Jan 2008. Like you my c-peptide was too high to get approved, I do not remember what it was. Byetta did not help - too many GI side effects. Blue Cross approved the pump based on how frequently I was testing (6 - 8 times per day at the time) and number of insulin injections per day (minimum 5 sometime more per day). Even though your A1c is great, maybe they would consider based on frequency of insulin injections.
It took me 2 years to get a pump but, the fight was well worth it. I was on 9 to 10 shots a day and having to test at least 6 times a day. You will want to keep very detailed records.
My suggestion is to keep fighting no matter what the insurance company says. When you get the denial from the insurance company then I would have the doctor reapply. Call the insurance company directly and ask them what kind of information they need in order to approve you for a pump. Check to see with your insurance company that if you buy the pump will they cover the supplies?
My insurance company made a mistake and let it slip that they were supposed to cover any item that I needed to control my diabetes. We took this information to the HR department and guess what I am now on the pump. Go to the HR department in your company and see what they can do for you.
Get some other people to go to bat for you. The HR department is one. The Doctor is another. The pump manufacturer is a third. The pump reps often know what the insureres are looking for, what buzz words to use, and what other factors to employ.