Kaiser coverage of Dexcom G4?

Hi: Kaiser insurance covered my Dexcom 7, and of course now I would like to upgrade to the Dexcom G4. Anyone with Kaiser had success with upgrading? Thanks in advance for your help/advice.

I assume that your 7+ is still under warranty. If so, I think that it’s very unlikely that your insurance will cover the upgrade. Most of us who upgraded to the G4 with an in-warranty 7+ paid the $399 fee ourselves. Dexcom would only deal with insurance for those users whose 7+ was out of warranty or who were purchasing their first system. I suppose I could have tried to get insurance reimbursement after the fact, but I didn’t bother since I knew my insurance wouldn’t cover the upgrade.

If your 7+ is out of warranty, then Dexcom will work with your insurance to get them to pay for the new system.

Good luck!

I am so happy with my 7+, and from what I hear and read about G$, I am in no rush to change.

The stickiness of the 7+ patches has improved so much, I do not need to reinforce it for 10 or 11 days with additional tape.

The accuracy is for the most part amazing.

What are the advantages of the G4?

The biggest complain I have about 7+ is that I can not check the data I have entered, on the receiver itself. i.e. I want to see how many units and at what time I injected last.

But they did not fix this in G4 anyway.

WOW! I switched to Kaiser last August (relocated). I am trying to get a new pump - mine went out of warranty 4 years ago and is wearing out. I get so much value from my Dexcom, that I thought I would try the MM Revel to have both a pump and CGM. I was told that Kaiser doesn't cover DGM. How did you get it!?!? I've been paying cash (and soon that account is gonna be used up)in order to "prove" that I would benefit from CGM and... that switching to MDI for a awhile to re-state my need for pumping.

Thanks for any tips on convincing the "powers that be" to rule in my favor.

Hi Melitta - Yes I recently just upgraded to G4 from kaiser, but I had my 7 bought through my prior insurance. I think kaiser covers med devices only once per a certain period. Not sure how long? But check out my post about getting it.


I am also a Kaiser member and have used the System 7 for 2+ years. My warranty runs out on March 31 and will be getting the G4 then. I spoke to the Dexcom folks and they need a purchase order from Kaiser. My endo department provides it and in my case the pump trainer initates the order. i am not sure what the copay will be but in my case since I am medicare I expect it to be 20% of the cost of the system and 4 sensors.

Hey Svensk! Hu mor du? Where do you live? I understand that different regions of Kaiser get different things. In Southern CA it's covered, but in the Pacific Northwest, only covered for children. So I guess that answers my original post. I spoke with the Dexcom rep and she told me about the age criteria. I hope to get an Rx for the Dexcom next week. I am goinig todoit out of pocket, but since the Seven+ is going to be discontinued, and I eventually hope to get the Animas Vibe that has the Dexcomj4 integrated to the pump, I need to get things started. I know that MM has an integrated pump/CGM but I've heard more comlpaints about MM than the Dexcom and animas. Thabnks for your reply

Thanks everyone for your replies so far! Very helpful.

Awesome! My dex7 was covered prior to my joining JKaiser. Where in the Kaiser service area are you? So far in the Pacific Northwest, all I have found to get covereage of CGM is for children.

Thanks for any reply

Hey Hey. Ya a fine. Ya laver i Denver Colorado. Var laver nI?

Jag laver i Portland Oregon - i dt Pacific North-wet!

I too live in Portland. You are right about Kaiser coverage in NW. However, I found that if you deal with Dexcom, they should give you the "Kaiser rate" for the G4 and supplies. I also pay out of pocket, but I save a bunch of $$$ by getting the Kaiser rate. Talk to Dexcom, they were quite helpful for me. Just curious, who is your endo?

I see Cheryl Goodrich RN CDE. I'd love to met Dr Glauber - I think we have some friends in common from either San Diego or South Africa. Anyway, I sent you a friend request. You're the first adult person with type 1 that I've met here in Portland. We moved here in November 2011. I was active in the San Diego Pumpers ggroup which was made up of people pumping (no matter what brand of pump) and people who were thinking about pumping would come. It was awesome, in that group wed worked with BilllPolonsky (auithoer Diabetes Burnout, John Walsh author of Using/Pumping Insulin, Steve Edelman founder of TCOYD and got to be testers for Dexcom.

I am getting the Kaiser rate, I just started on my Decom 4 this week after several years on the Seven + I do need to get a new pump, if the Vibe comes out before mine gives up - of course I'll go with that. I was toying with the Minimed Revel with CGM, but I am real happy with Animas, and since Dexcom has a better CGM I am sticking with them.