Medicare is not approving the G3 sensors because they “control” insulin infusion in auto mode. Apparently, more research is needed before the FDA will approve the G3 because the FDA wants to be sure it is safe to control insulin infusion with the Guardian 3.
This is also the reason Medtronic wants to keep 670G patients’ BGs around 150 to avoid hypoglycemia.
Yes. Thank you. I am aware of the reason Medicare is not approving the G3.
I think there are more good reasons to approve than not…so going thru with appeal.
8000 approx a year is not what we can afford for the sensors so we must try to appeal.
Best to you as always, Don.
Sally
Medtronic charges $340 for a box of five G3 sensors if you do not have insurance or $3536 per year. If you can extend their life for an extra 7 days, that will reduce your cost to $1,800 per year. However, that is still a lot of money and worth fighting for.
I have twice appealed to my Medicare Group Advantage Plan and been denied.
Good info Don. I checked the Medtronic site but do not see that info. Do you have the link from the Medtronic site.
Thanks Don.
Sally
Sally, I didn’t take it as that, at all. I REALLY appreciate your support. I believe, together we may make a difference. My wife and I raised TWO type 1 kids. They are adults now, both on the same pump as I am and they are doing well. The problems we have experienced with all that type 1 has been more about idiots than the disease itself. What I mean is:
Primary care physician that took my son off of insulin.
A doctors office putting my code in as a type 2 diabetic causing insurance to Denny even pum[ supplies.
Medicare not allowing CGM sensors
Endocrinologists that say my A1C of 6.5 is too low and the next one saying I could do better
A endocrinologist that refused to give me a script for pump supplies and wanted me to PROVE I knew what I was doing (despite a 6.9 a1c at the time) insisted I go back to MDI. Obviously I walked out of the office.
Insurance wanted me to PROVE I’m a type 1. I had to do every test in the book before they acknowledged I was a t1.
The list goes on. Sorry for being long winded but it’s been a battle to get the tools I need.
Bob
All of this sounds like much of what we have been thru.
I just had a long talk with Vanessa, the Maine Diabetes Consultant for Maine at Medtronic and asked her:
It is time the dots started getting connected with Healthcare in this country. It’s about collaboration and connecting for the benefit and care for each other as human beings!!!
What is in the works for some sort of 700 pump so we under warranty can trade our sensor less 
pump in and get this new one where it will be approved by Medicare. She does not know and cannot reveal anything she knows until the FDA gives approval but says she believes something is coming down the pipe.
Vanessa is sending me a financial aid form. I will look at it but doubtful we will qualify but worth a look.
This is not just about you and me Bob. I know you know that. It is for people we don’t know who may have some sort of barrier to being able to communicate their horrible situation.
I was very calm and respectful when I talked to Vanessa of course.
My husband and I are taking action. He is in the process of writing Senator Collins of Maine who is on some sort of Diabetic Caucus. And appealing Medicare and our secondary health insurance company.
Best to you as always, Bob.
I do not have a link to the Medtronic web site. However, if you call Medtronic and try ordering the G3 sensors, they should tell you the cost. All I can tell you is that $340 is what they charged me and I have a copy of the paid bill.
Hi Don. I got this figured out. If you pay out of pocket with not involving insurance that’s what you pay. If it gets submitted to insurance it is twice that. And if, in our case, the G3’s were submitted to Medicare and they were not picked up by our secondary insurance they still expect 1800 plus dollars out of us.
I cannot find the 345 cost on website at Medtronic.
Not happenin’ Gonna fight that too.
Thanks Don.
Best to you as always.
I wish you the best of luck with this very long and costly battle.
Thankyou. It is going to work out. I will let you know the outcome.
Best to you as always,
Sally
Hi Don, Checked on the 345 per box for sensors. Nowhere on website. Sigh!!! You are indeed correct. Thanks for your help.
Best to you as always.
Sally
Sally, have you tried calling Medtronic and speaking with their order department? I had to buy a box of Enlites a few years ago, they gave me a price of $280. I know they lower the cost if you buy them outright. You have to call a specific department. Good luck👍
Yes Jason. I called. I have a contact there now who is the Maine Rep. Thank you for communicating this info.
I am in the process of appealing my private insurance company and Medicare.
I think it is important to speak up by appealing.
Best to you as always.
Keep at it and don’t give up. I wish I could help you, but unfortunately I have to cheer you on from the sidelines.
What a nice thing to say. I will let the group know how it goes.
Best to you as always.
Sally
Bob how are you doing with the sensors? Do not pay the 1800. You should only pay 345 per box.
Sally, sorry for delay. I’m doing ok. My daughter had a bunch. She decided not to use it so, I took them! I’m getting anout 11 days average now so I should be able to stretch my inventory to 6 months. After that I’m going to go ahead and get back on dexcom. I prefer utilizing the advantages of minimed s pump/cgm but I can make do. Sucks but I’ve tried everything regards
Bob they have just submitted to FDA new info about the sensors for the G3 Sensors. Not to be nosy but did you appeal? It bugs the hell out of me that you as a veteran do not get whatever you need. I am sure you do not want to hear that. Don’t get me wrong. I think all diabetics should get a break. We do not do enough for our military. Also on the Medtronic website I saw that there is some sort of discount if you have more than one diabetic in the family. Probably but I don’t know but maybe you have to all use Medtronic. You should check. I think of you and your family, Bob. 
One more thing. We have appealed to Medicare and our secondary insurance company and I am fighting tooth and nail for that appeal, not just for us.
Thanks much Sally. I have myself and BOTH of my children with type 1. We are all on the 670g pump. My daughter chooses not to bother with the cgm any longer. My on uses the dexcom sensors and he likes it so his wife can easily monitor and help. Yes I Did appeal to Medicare with a nice write up from my Dr. my secondary is Tricare (through my naval service). They approved the sensor but they only pay 40% I think. With Medicare paying zero, that leaves me owing Medtronic close to $1,000 from two 90 day orders. They will not be shipping out any more orders now until I pay them (which I can’t at the moment).
3 years ago I got stage IV bladder cancer. I had to have my bladder removed. My nav insurance (Tricare) refused the robotic surgery and said I had to go to the military cancer hospital in Mississippi for convential surgery and 90 to 120 days of rehab vs 5 days in patient and a couple of weeks of home bound care. Plus I would have to use a bag the rest of my life vs a Neo bladder made from my intestines. I called my congressman and said I have a Purple Heart and Navy commendation and 27 years service and they won’t help. Within 6 hours I was told Tricare had approved me for immediate surgery. Ugh I hated pulling that card but I wanted to have a quality of long life.
My long winded point is; I learned to fight! I will continue. I so appreciate your concern and support and hopefully we both can get good news. Sorry for being long winded
August 21Thanks much Sally. I have myself and BOTH of my children with type 1. We are all on the 670g pump. My daughter chooses not to bother with the cgm any longer. My on uses the dexcom sensors and he likes it so his wife can easily monitor and help. Yes I Did appeal to Medicare with a nice write up from my Dr. my secondary is Tricare (through my naval service). They approved the sensor but they only pay 40% I think. With Medicare paying zero, that leaves me owing Medtronic close to $1,000 from two 90 day orders. They will not be shipping out any more orders now until I pay them (which I can’t at the moment).
3 years ago I got stage IV bladder cancer. I had to have my bladder removed. My nav insurance (Tricare) refused the robotic surgery and said I had to go to the military cancer hospital in Mississippi for convential surgery and 90 to 120 days of rehab vs 5 days in patient and a couple of weeks of home bound care. Plus I would have to use a bag the rest of my life vs a Neo bladder made from my intestines. I called my congressman and said I have a Purple Heart and Navy commendation and 27 years service and they won’t help. Within 6 hours I was told Tricare had approved me for immediate surgery. Ugh I hated pulling that card but I wanted to have a quality of long life.
My long winded point is; I learned to fight! I will continue. I so appreciate your concern and support and hopefully we both can get good news. Sorry for being long winded
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August 20Bob they have just submitted to FDA new info about the sensors for the G3 Sensors. Not to be nosy but did you appeal? It bugs the hell out of me that you as a veteran do not get whatever you need. I am sure you do not want to hear that. Don’t get me wrong. I think all diabetics should get a break. W…
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