IF I were to go on Kaiser, does it cover Enlite, pump, and strip supplies pretty much like a good PPO plan? I have Aetna now and may have to switch to either Medicare or Kaiser. There is a document online that states that to get CGM with Kaiser you have to be with one of their endos for SIX MONTHS and show a number of below 50 hypos before they will prescribe a CGM. Good grief, I’ve got somewhat decent control NOW, BECAUSE I have a pump, a CGM and test plenty. Seems like I’d have to destroy my good control in order to get them to give me ongoing supplies for a CGM if I were to start up with Kaiser.
I have a Medicare Advantage plan with Kaiser NW. I think coverage partly depends on which region of the country you live in. I believe Kaiser in California does cover CGM in certain circumstances.
I have an Animas pump & I have no co-pays for pump supplies or a new pump when I need it. Kaiser covers Medtronic, Animas & Tandem pumps. I recently bought a Dexcom CGM which I had to pay for out of pocket, however I did get the receiver, transmitter & sensors at Kaiser’s reduced price which is a savings.
The 6 month Endo visit rule also applies to pump coverage, but I don’t think they will make you give up your existing pump for 6 months before they wil cover pump supplies.
Thanks, Annabella. I’m in Calif and may be for a couple more years. Sounds awesome that there is no copay. I’ve been trying to figure out the whole Medicare deal but am so confused I may call the local office to make an appointment for a face to face with a social security employee to help me understand all the options. I tried getting some of my questions answered at the Medicare site but didn’t make much headway. Thanks again!