Medicare/Dexcom October G6

I’m highly allergic to surgical tape. It causes my skin to turn red and blister. I’m very fortunate to never have a reaction to my Dexcom before the change of adhesive or after. There are others who do, and I hope Dexcom can find a solution that works for everyone.

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I am glad I am not bothered by any of it (well, except it falling off too soon! )
That being said, I almost wish they had two versions, one with super adhesive for ‘most’ people.
And a second option for people that have issues with the adhesives. There are plenty of people in this category, but I feel that they are not making their product as good as it could be for the rest of us.

I agree. Having to spend extra money on skin tac/skin tac remover just to get the sensor to stay on, bothers me. Before they changed the formula, the G5 felt like it was super glued to my body. The 2 different versions is a great idea. I highly doubt Dexcom would implement it.

A bottle of skin tac is very cheap and should literally last for a couple of years or more (not to mention how highly effective it is).

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Not worried about the cost. Having to aquire additional supplies to get the sensor to work as it did in the past is the part that bothers me.

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Ah, you mentioned “cost” in your previous post. :slight_smile:

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Sorry. Wrong choice of words. I should have said I don’t like having to find said products. The only place I’ve found that stocks them is Amazon. I have to set aside my disdain for Amazon to get them.

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LOL. I hear you.

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Usually for me the limit to how long I could extend a sensor has been how long I could keep slapping tape over it before the whole mess just pretty much fell off. Toward the end of my time with the G5 it seemed like I was suddenly getting two full sensor sessions with just the regular sensor adhesive and Skin-tac, no over-taping required. When I first switched to the G6 it was even more obvious b/c of the longer (official) sensor life. I thought it was because I’d finally figured out the Perfect Adhesion Formula (really just alcohol swabbing the area, letting it dry, applying Skin-tac, letting that set for 5 min., then inserting the sensor—genius!). Then I had a couple of sensors that started coming off after like three days, had to resort to overpatches, tape etc., and I kinda figured it had to be something Dexcom was doing. More recently it’s been back to 20 days with just Skin-tac, so yeah, it seems like they’ve been fooling around with the adhesive formula on their side. I’m not especially sensitive to the stuff so I’m hoping they stay with what they’re doing right now. I got some of the Dexcom patches when I called to complain about the last bad one (Dexcom will send them free, if you ask), but so far I haven’t needed 'em.

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Over the last few months I’ve noticed that the perimeter of the sensor edge will either immediately start to curl and not stick properly or stay on for 2 weeks without any extra tape/skin tac. You’re most likely correct in saying Dexcom is messing with the formula.

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Had an endo appointment the other day and they said there was a special program for X2 users to get the G6. They submitted paperwork to Dexcom. Someone from Dexcom called me and said no Medicare patients until maybe 4th quarter. Period, end. I emailed doc’s office and they said the Dexcom person was wrong. They contacted Dexcom and evidently it’s in the works but I will get the G6 as a prescription from Walgreens, not from a DME. Be interesting to see what really happens. My overriding reason for wanting the G6 is the acetaminophen thing. I can’t take any NSAIDs so that that leaves nothing for back pain except the hard stuff. I don;t want to go down that road.

And the beat goes on…

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This sounds very strange. From what other Medicare patients have said, if you are on Medicare, you have no option but to order directly from Dexcom. As far as, secret programs that nobody knows about to supply the very fortunate whom know the secret password with a G6, I wouldn’t hold my breath.

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I have not heard of any Medicare patient yet get the G6 under any circumstance and have Medicare pay for it regardless if the patient gets their Dexcom supplies directly from Dexcom or through one of the 3rd party suppliers Dexcom has approved for Medicare patients in a few select markets. I would believe that there is a possibility of a Medicare patient receiving a G6 and either paying for the G6 out of pocket or having a non-medicare related insurance policy to cover it.

Medicare patients are currently only being shipped with costs covered by Medicare the G5 and supplies for the G5. G6 is still being currently scheduled to start to ship to current G5 Medicare patients in Q4 2019. That means after October 1, 2019 and additionally approximately when G5 transmitter is due for replacement. So if your G5 transmitter is not scheduled to be replaced until December 2019, for example, you will not be upgraded from G5 to G6 until December even though some Medicare patients may have received the G6 starting October 1.

Additionally, of course, all other terms must be met as well such as insurance verification up to date, doctor notes up to date etc.

I agree with you. Everything @zander has said goes against what you are saying and what every other Medicare patient have said on this forum and others. If Dexcom does have a secret special program for certain Medicare patients, who qualifies? Who do you speak with at Dexcom? I call BS on this one. If said program does exist, it’s discriminatory.

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I totally agree with you but as you know in life there is always one exception someone hears about and thinks that is the rule. I mentioned a couple of ways a medicare patient could actually be on a G6 and a few more that come to mind is that a select medicare patient could be on some sort of Dexcom trial or Dexcom Warrior or other marketing program.

No point wracking our brains about a very remote possible exception. The policy is as I have stated above and if any group of Medicare patients are getting the G6 outside of the general policy, we would all like to hear about how they are doing it.

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I’m sure if there was a way for a Medicare patient to receive the G6 on some secret program, not any of the examples you listed, we would have heard about it by now. Until Dexcom has successfully billed and shipped the order, I’m not believing anything. Having to take Tylenol and nothing else, is not going to persuade Medicare to give an exception to a very rigid set of parameters.

I talked with a very nice guy from Dexcom today and he said that the last he heard is December for the G6. I going to try to get one through my regular insurance plan and I hope that I will be able to get it through my local pharmacy.

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Both Walgreens and CVS are able to provide the Dexcom.

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Great. Hope my insurance plan is ok with that.

@Marilyn6
Assuming you are replying to my post about Dexcom from CVS or Walgreens via Pharamacy Benefits …

My suggestion would be to not bother discussing or asking your insurance company. IMHO that leads to confusion and is often not the final word anyhow.

What I did was simply ask our Endo to send a prescription for the Dexcom G6 transmitter and sensor (for which I provided the Dexcom suggested prescription sample to our Endo and asked the Endo to write the script exactly as Dexcom suggests) to our pharmacy.

I am already aware that both CVS and Walgreens have the capability to fill Dexcom scripts for G6 transmitters and sensors.

After the script was send over, I went to the pharmacy and they were not sure exactly what these were (first time locally for them) so I provided the data sheet from Dexcom that has the NDC codes. The local pharmacy tech found that super helpful.

2 or 3 days later, the script was filled and ready for pickup.

I had completely ignored my insurance company up to this point. I had no idea if it would be covered or not. The pharmacy already has my insurance info as this is our regular local pharmacy.

I went to pick up the filled Dexcom script which contained 1 G6 transmitter and 1 box of three G6 sensors. At that point, I asked the pharmacy tech what my out of pocket cost was. If it was higher than I was willing to pay, I would simply tell them I was not paying that much and refusing the items and they could return them to stock. I am well aware this happens all the time at the pharmacy counter and it makes no difference to the pharmacy techs. They are used to this and it does not bother them in the least. However this was the only way I thought that I would REALLY get the actual cost to me. Anything else including calling my insurance company would only be IMHO a possibility.

Turned out cost was lower then via DME supplier I was previously using so I picked up the prescription.

Since then the sensors have been on autofill so I get a txt msg about every 28 days or so letting me know the next month supply of G6 sensors is ready for pickup. The G6 transmitter, I call in manually for a refill every 90 days or so.

BTW - I always check the dates on the boxes before walking away from the counter just to be safe. So far they are always extremely current.

PDF Attachment from Dexcom
“Filling Your Dexcom G6 CGM System Prescription at the Pharmacy”
LBL016867 HCP to Rx Summary.pdf (2.1 MB)

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