Just found out my insurance covers CGM's

We recently moved from Hawaii to California. Immediately, I found Kait a new Endo. Three weeks after that appointment, the endo informed me that she no longer accepts my insurance. So, I had to find a new Endo. Our appointment with the new Endo is in two weeks. My question is: Will an Endo prescribe a CGM at the first visit? Since we know our insurance will cover the device, we’ve been researching CGM’s and have decided to go with the Dexcom Seven+. I am anxious for Kait to get one and would love to get the process started sooner rather than later. Thanks

I don’t see why not. Typically the hold up is insurance and not the medical professionals. Good luck. I hope you don’t get any resistance.

I wouldn’t rule out that they would prescribe on on the first visit. I would hope that you have records from your prior endo that help provide the documentation that insurance companies like to see to support your request. The Dexcom people have forms for you to fill out that are very well-designed to ask all the right questions. I would contact Dexcom ASAP and get them to fax you the forms, in case your endos office doesn’t have them. Good luck!

If you go to DexCom’s website, they have forms that you can download and print. I’d bring them to the new Endo’s office on your first visit and ask that they be completed right away. I think most Endos like for their patients to use CGMs, and if your insurance has already given the green light, what do you have to lose?

Thanks for that tip, Shannon, I didn’t realize the forms are online.

I’d make sure you have detailed blood sugar logs for the Endo at the first visit. Generally they need to sign forms indicating medical necessity. If they can see you have Hypo-unawareness, Wide swings in sugar levels, or unacceptable A1C’s (get these from your old doctor) then this shouldn’t be a problem. Go in with the right documentation and you should be fine.

Thanks for the input. I’m getting all the info together so we’ll have it at our appointment. We’re so excited! : )

Endo should prescribe this. At this point, with all the recent documentation available, it is the insurance companies that are the holdouts. If the endo will not prescribe what you need, call Dexcom and see if they will give you the number of an endo near you that will. You can always switch back to your original endo later on if you want to. You will love the Dexcom 7 Plus.

Cool, thanks for the thought. I never thought of going that route, but since the new endo belongs to the same group as the old endo he doesn’t accept my insurance either. I’m going to take your advice and give Dexcom a call. Maybe they can recommend some wonderful pediatric endo’s in my area. I’m sure we’ll Love the Dexcom 7 Plus – if we can just find a doctor to prescribe it. Mahalo Nui Loa for your help and kindness! (Thank You Very Much!)

Just wanted to say thanks to all for your thoughts. I found a great Doctor for Kait and he actually did prescribe the Dexcom Seven+ for Kait at the first appointment. My insurance required us to get a pre-authorization prior to purchase and Dexcom submitted it for us. After an agonizing 11 days, we were informed that the Insurance company gave their go-ahead! We received the Dexcom today and will meet with the CDE tomorrow for training. Kait is thrilled and so am I. Thanks again!