Medicare and the medtronic CGM


#1

i just got off the phone with my rep at medtronic and medicare doesnt cover their CGM and it would have to be a cash pay. even if i did a medical of necessity letter it wont help. i guess dexcom it is! if anyone managed to get medicare to cover the medtronic CGM let me know how you did it? its a shame that they dont cover it at this time


#2

Dexcom is better anyway and that might be why Medicare decided to go with only the Dexcom unit but that’s just a guess. Dexcom is the only unit that I want to use as I’ve used Medtronic sensors and I wouldn’t give you one penny for them.


#3

i was looking forward in havig just one unit. i can get the G5 and not the G6. medicare will cover the G5. the G6 may not be on their radar at the moment. at least its the same sensors as the G4…i just need the transmitter and reciever


#4

We’re on Medicare here and we love our G5s and I don’t really feel left out by not being able to get G6. G5 works great. Some people just have to have the latest devices. I don’t find that there are any serious downsides to the G5


#5

the medtronic pump is the 630G the latest is the 670G. so i have the 630G as that is the free trade in for those that are on animas.


#6

I think it is very interesting that in the Medtronic release I saw, they very specifically mentioned that one needs to do a finger stick before dosing insulin. Until Medtronic gets the FDA to approve the Guardian for insulin dosing without a finger stick, it will not be approved by Medicare. I think that Medtronic will eventually go that route, but now they can hardly keep up with the demand with private insurance.

I personally am a Dexcom fan and it will take a lot to get me back to Medtronic. But I am not a Medtronic hater. I liked my MMT pumps but abandoned the company after the horrible SofSensors. I have lots of issues with adhesive allergies and would probably struggle with the taping required for the Guardian transmitter/sensors. But I hope they do great because we all benefit from choice and a robust technology market.


#7

it seems that a lot of people who are on the medtronic pumps uses the dexcom. I have the G4 but i really wanted to try the CGM on the medtronic so i had one unit vs two. i guess Ill have to get the G5. hopefully some day medicare will cover all of medtronic products


#8

It will help us all if Medtronic gets their sensors approved by Medicare. But right now the onus is on Medtronic who has not done the work to get their sensors approved by the FDA for insulin dosing and thus eligible for Medicare reimbursement.


#9

interesting. so its medtronic that needs to work on getting medicare to cover them?i dont get why medicare wont cover it. its the same as dexcom


#10

No it is NOT the same as Dexcom. MM sensors are not as reliable. Why should Medicare pay for inferior products that are going to cause patients problems? I used their sensor for over a year and that was a sleepless year for me, thanks to the many issues with those blasted things. MM is LUCKY that ANY of their models were FDA-approved. Seriously. I do like my 551 pump though. It’s simple, small and ultra-reliable.


#11

I hope eversense get medicare approval

Using Libre now


#12

I switched from Medtronic to Dexcom because of the Medicare issue (I’m new to Medicare). Two things I noted:

  1. Dexcom was a dream to deal with. My endo’s office contacted them, they called me, 10 minutes later we were set up. I had the sensors within a week. My interactions with Medtronic we’re all similarly impressive.
  2. Dexcom sensors blow Enlite out of the water for reliability and accuracy. Its more work keeping up with separate reports for the pump and sensors, but worth it imo

#13

No it is not the same because the FDA has not approved Medtronic sensors for dosing insulin. The lack of Medicare coverage for any sensors was related to the fact that they just duplicated BG meters. When the Dex was approved for dosing insulin without a BG test, that opened the door for CGMs to be a primary device not a secondary device. Medtronic knows what they need to do. They have just not done it.


#14

Yes–they need to step up their game. You would think that Medtronic would have resolved their sensor accuracy issues by now. I’m still perplexed about them receiving FDA approval for the Sof Sensor and dubious that they should have gotten FDA approval for the Enlites.


#15

What incentive do they have to do that - the sheep keep buying them?

It’s easier to make fancy color brochures to convince medical staff to recommend them


#16

My husband got a MM670g and sensors with a Blue Care Network Medicare Advantage plan. Since he has dementia, I manage his pump and this pump works well keeping him free of hypos. The sensors have been accurate.

I chose a tslim and Dexcom for myself and have to say I like the Dexcom much more than the MM Guardian sensors.


#17

I am a member of several T1 support groups, and I keep reading about the Medtronic sensors having poor accuracy. Many users have stopped the Medtronic sensors, and are now using Dexcom. I am using the Medtronic 630 pump and a Dexcom G5. When I change pumps again I will use the Tandem pump which is integrated with the Dexcom.


#18

I also don’t want to continue upgrading to only MM pumps. They have lost their mojo, IMO.


#19

I had a Medtronic cgm years ago that I paid for out of pocket. Looked like a sea shell. Used it for a minute and a half. Hated it. Hurt to put in only lasted 3 days and was always alarming. Going to try the Dexcom if Medicare will approve. Was at a pool in the sunlight today and couldn’t see to test. Starting to be annoying.


#20

Good news Dave. Have been approved for the Dexcom. Will be on way as soon as it sits in on warehouse for 9 days. Not sure why that is but ok. Will probably have a lot of questions when I get. Especially how to extend time I can wear. Thank you for your help.