I had heard about the drastic cut in number of strips allowed. That is how they plan to save money. But with regard to “you cannot use the connection factor” — how in the world would they ever know?
I do not know. However, that responsibility could fall on the supplier of the transmitters and sensors and blood glucose strip allin a single order.is one possibility.
Dan
Can you elaborate on your statement about Medicare decreasing the amount of test strips. I have a hard time keeping up with all the new changes. I have sent my first appeal for CGMS ( Medtronic) and have received the denial. Sometimes I feel like I would rather use all this effort( fighting for coverage) to keep healthy. The stress is really becoming a factor. I don’t look at it as giving up the appeal process but just changing my focus to my own personal needs and working out positive ways I can develop to get along with less strips and sensor coverage.
Hi KAK,
Here is the link. CGS Administrators, LLC
Check out the paragraph which begins . . . ." The supply allowance for supplied used with the Dexcom G5 encompasses items . Look at the list on the items which are proposed to be linked to the DME category for the Dexcom G 5.
Ok for those that have been waiting on a CGM to be covered by Medicare as most know Dexcom G5 will be the only one right now. But nobody was quite sure who would be the supplier. Liberity dropped out as did the rest.
After just speaking with Dexcom they will be doing the supplying them selves. Rep that I spoke with said the decision was just made. Said about 4hrs ago, not sure about that, but 
Anyway those interested go to Dexcom web site fill out questionnaire took them about 15min to get back to me, no joke.
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Hi KAK,
There is a more recent notification which is dated May 4, 2017 regarding this matter.
Read item 5.
Continuous Glucose Monitors – Frequently Asked Questions
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Continuous Glucose Monitors – Frequently Asked Questions
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It is far more comprehensive. It includes, blood glucose strips, blood glucosemeter(s) and batteries. Really???
Dan
So I just started on my Medtronic 670g in auto-mode. I’m 2.5 years away from being forced to go on Medicare or get Medicare Supplemental or MediGap??? The 670G won’t work in AutoMode with Dexcom anything. Do we know if Medtronic is actively pursuing Medicare coverage for their CGM and closed loop system?
A Medtronic rep told me yesterday on the phone that they were pursuing the Medicare coverage for CGMs and that “some Progress” had been made, but no specifics.
Dan your post is messed up. The FAQ as developed by Celerian Group summarizes a DME MAC Article (Celerian is a major administrator on behalf of Medicare). Part 5 says:
- What is included in the supply allowance code A9999 (K0553 for DOS on or after July 1, 2017)?
Response: As noted in the March 23, 2017 DME MAC joint publication titled Coverage and Coding – Therapeutic Continuous Glucose Monitors, the supply allowance for supplies used with a therapeutic CGM system encompasses all items necessary for the use of the device and includes, but is not limited to:& CGM sensor, CGM transmitter, home blood glucose monitor and related blood glucose monitor (BGM) supplies (test strips, lancets, lancing device, and calibration solutions) and batteries.
Note the date and the changed supply allowance code
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My CGM and 640G (not yet available in the US?) minimed pump actually collaborate to TREAT my hypo’s- it stops my basal delivery automatically when I approach my designated lower limit And automaticcally starts again when My bloodsugar reaches my ‘normal’ range. Has helped to lower my A1c. Isn’t it interesting that It has not yet been approved for use in the US!?!? Would that solve thiis issue and help us!!!
Karen,
in the US, we have the 630 that is similar to 640, which suspends bolus when BG is low.
Also have the 670, which is the next generation, that has ‘auto mode’, where it both suspends and increases basal rates, and uses the new Guardian3 sensor.
This discussion is regarding what Medicare covers in US, which is not always the latest and greatest from Medtronic.