I am in the process of switching to Medicare. Because Medicare will not cover the Enlite sensors for my Medtronic Guardian 3, I am working on figuring out how to get them as cheap as possible. Has anybody else had to do this, or have any advice on how to do it? I will admit that I have never used anything other than Medtronic, but one of the things I like about it is Auto Mode (where the pump automatically & dynamically adjusts the basal based on the CGM numbers) and the fact that it is a single device. I have, however, been told that Dexcom has more accurate numbers and does not even require a meter, but that it does not have the CGM and pump as a single unit. I am completely confused about what capabilities everything has, whether I should switch, and how to deal with Medicare. Auto Mode & having a single unit are very important to me, but I also need to figure out how to get Medicare to pay for stuff and/or get it at an affordable price. Any ideas or suggestions? Thanks.
The Tandem Tslim X2 pump is integrated with Dexcom G6, and I recently switched this year. I had used Medtronic pumps for 25 years, and the early Sof-sensors before Dexcom. Tandem X2 has similar integration, adjusting insulin based on dexcom data.
Is your medtronic pump still under warranty?
It might be helpful if you went to Tandems web site and read about their pump and software available. The best part that your doctor can work with Tandem and get Medicare to pay most of the cost of the pump and supplies. They will also pay most of the cost of the sensors. Being knew to Medicare might make a difference. Your Endo should know most of the answers.
Here is long discussion on medicare and sensors.
@Sally may be able to give update and status on progress with Medtronic sensor coverage. I think she got a discounted cash price.
https://forum.tudiabetes.org/t/medtronic-670g-guardian-3-sensors-medicare-coverage-update/
on September 18, 2020 Medtronic released the following statement related to the Guardian 3 sensor.
This is for people who use Medtronic sensors and who do not have insurance support inducing Medicare. here is the announcement in its entirety:
*** Official statement**
We are thrilled to offer the CGM Access Discount for people who don’t have CGM insurance coverage, including those on Medicare and want to use the full Medtronic insulin pump system. Our hope is to help reduce the burden of cost when it comes to those who don’t have coverage, by offering CGM transmitters and sensors at a discounted rate. We’ll have a webpage and flyer for you to share soon and will post it once it’s ready. Until then, to verify eligibility, customers should call us at 800-646-4633 (Mon-Fri 8am-6pm CT). Interested in a CGM transmitter and sensors, ext. 21629, interested in sensor reorders, ext. 21063 and interested in an insulin pump, ext. 21055.
The program is in effect at this time.
Rick Phillips
My required disclaimer.
I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things. OK, they sent me a shirt and a cup but even I am more expensive than that.
Thankyou. I hope you will post the poster when it comes out. I will call at some pt. But will wait for poster. Hopefully it will be out soon.
I am on Medicare and use Byram. If you choose Byram there are several points to learn.
(1) they have a quirky system to get around their way of assuring Medicare compliance. They ship 3 G6 sensors every 31 days. Wait, they get over the system by sending an ‘extra’, off the books, sensor every 6 months. Weird, but it works.
(2) Byram sometimes looses doctor’s paperwork. My solution, get a copy of everything sent to Byram by doc, scan & keep it at home. When Byram says "no doctor paperwork’, I say not to worry and email it while still on phone.
(3) Get a personal point of contact & a backup at Byram. Work only with these two people not with an entire call center. Doing this establishes an account ownership relationship.
(4) Get a notebook, yes I am old fashioned, and keep every piece of correspondence between you and Byram. When someone says on the 45th of Juvember, correspondence said… You have it.
Let us know how this turns out. Sharing helps us all learn.
Hey @Rphil2, what is a Medtronic ambassador. Never hear of such a position or title in 25+ years as a D.
Cheers.
Hi Jay,
Being an ambassador is voluntary It does not take to much, we offer to help people who might be having difficulty with Medtronic products, or services. Sometimes we can offer a back channel to a higher level of support but really it is just listening and helping.if we can.
Here is a compete explanation.
Because this is pharma and is so regulated, we are required to disclose that we are associated with Medtronic whenever we comment on something that might be thought of as influencing someone to use a Medtronic product or service. I take it a little further than most but I post in TUD a lot so I really do not want any confusion.
Rick
I am in the same situation. I could have picked a Medicare Advantage Plan, one or two of which cover Guardian 3 sensors. My Medtronic pump’s warranty runs out in December. I went with Medicare and Medicare Supplement plan. I just got a Dexcom G6 which I’m wearing for a couple months in combination with my Guardian 3 sensors until I can move to a TSlim with Control IQ. I don’t have to calibrate the G6 which is huge. Plus after the mandatory Medicare deductible there’s no copay on CGM sensors and pump supplies. As a Type 1 since the Stone Age I have but one opportunity to go to Medicare and Medicare Supplement health care without the typical pre-existing condition penalties. I’m more comfortable with the Medtronic system but it seems that the Dexcom G6 sees coming highs and lows a few minutes faster than my Medtronic. But what a hassle! I think Medicare is dispensing with some of the qualifications required because CGMs proved valuable for diabetics with Covid-19.
Thanks for the ambassador’s info site. I ponder if any folks here are invested in any of the big pharma diabetes companies?
Well I have about 5K of my retirement in Dexcom, and I own shares of CVS, and Pfizer. While I do use CVS, I do not use Dexcom or Pfizer products. I just believe in their corporate philosophies and financial position.
I own Lilly stock. Although I think they are a big part of the problem with the price of insulin.
I bought the stock when I started humulin in 1990. And just held it.
As it turns out the company I work for and Lilly are contracting together for instruments etc.
I will be on site there often.
I wonder if they will give me free insulin.
I mean it’s supposed to be as cheap as water but somehow it still costs $500 per bottle if you have no insurance.
When I started humulin in 1990 it was $16 per bottle and my insurance paid $15 of it.
Now it’s more than 20x that