Just found out they will not pay for CGM. This after 5 weeks of forms, faxes, and doc. visits. I already KNEW Medicare doesn’t cover and feel tottally unsatified with my time spent dealing with Abbott. They originally explained to me that with their help and following steps 1,2,3 bla, bla, bla I would get insurance approval.
No one needs a CGM more than I. After 56 yrs. of Type 1, I feel almost no signs of hypo. coming on.
At this poiint, I am really depressed.
Any help or just a comment and I will at least feel someone gives a ■■■■.
Jim
Jim:
I feel sorry for you and your plight. I have driven myself half crazy with trying to understand the “insurance” industry. And I consider Medicare a giant insurance company with federal ego.
I am seeing some of that myself with the scooter issue. See my blog and/or profile on my site. 
Take care and take hope. Try an appeal. Then you could probably state your case more eloquently than on paper with facts and figures and nothing of you.
My friend fought for 3 years for disability for fibromyalgia and other health issues. She finally won when it went before a panel of judges not employed by Medicare. A lawyer, doctor and something (!) else. They will try to do eveything from losing files, senseless delays, jackass opinions, etc. but hang in there and try again. OK?
Lois La Rose
Milwaukee, WI
Thanks Lois, nicely said.
I already am on disability.
I will get the appeal process started first of the week but with no expectations, this time.
Jim
Hi Jim,
I am sorry for the problems with Medicare. I have been down a long sorry path with them on numerous occasions myself. I believe the problem to be the people they hire into certain positions. I realize there are guidelines to follow, but there is a certain meanness in some people. On 3 separate occasions when Medicare called me to check on medical equipment I had here at the house, they also asked certain other questions as well. On each of these 3 times the words were as follows “and have you been in the hospital within the last 3 months”? to which I had answered no. Then the words " well if you haven’t been in the hospital and you aren’t dead yet, you can’t possibly need anything else". To which, I had no comment and they hung up. These times hurt me, but there is nothing to answer to so cruel a comment, especailly after I had just gotten out of Intensive Care 4 months prior to the questions.
Sometimes it isn’t how hard we struggle. Sometimnes it is truly just the other person. I can only hope and keep you in my prayers Jim that soon you will get someone in there who cares enough to move the pencil over to the acceptance box. I wish you well. I have waited for three months to get my pump approved. Hope and know that all of your family here is with you
I know this doesn’t do much good right now but in a year Medicare will be covering the CGMS. What they want to prove you need it I don’t know. But they do have billing codes for it, but haven 't made contracts with any of the CGMS companies yet.
Jim:
I am not on medicare as yet, I am close, if SS will approve my disability, UUUGH a different long story. Anyway, I am so sorry about the disapproval. As a 34 year diabetic I certianily cannot feel low BS’s it is jsut awful. I hope things get better I know if I did not have a CGM I would have died a few times these past three years. Yeah it is that bad. It is just that no one who does not face it really understands it.
Rick Phillips
It isn’t the pump companies, it is Medicare. They will give billing codes out and then not cover anything right away. It has nothing to do with the pump companies not wanting Medicare to cover it. I know it is unfair, I have a CGMS but i paid out of pocket for it from lawsuit money. Right now I can’t afford to buy more sensors for mine so I was hoping Medicare would start covering it,but I talked to my rep at MM and he said it will be a year at least before they have contracts.
Jim:
It’s me again. I agree with a lot of things, but not the principal of insurance companies. Medicare is the biggest one of all. And I truly believe that they turn down large ticket items for two reasons:
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They hope you croak off before the have to approve it.
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They hope you will lose patience and give up the fight.
Yes, they hire really mean people. That is what they are paid for … to find a way out of paying and keeping the costs down.
I confess that I’ve had pretty good luck than the average standard with Medicare. Three times they approved equipment for me (some after a brief argument) even after the provider (Visiting Nurse’s Association in Milwaukee) had said they wouldn’t give me one because Medicare wouldn’t pay for it. I told them to send it to me anyway because I had called Medicare and found out what the loophole was!! So, you see, there is a way out of the maze. You just have to send in a good sob story person or a whiner. Fortunately for me, I am both!!!
Expect to succeed and you will succeed. Have faith and believe and it will come to fruition!!
Lois La Rose
I shall do, Lois! I’ll keep at’em till’ they burn my house down. Regardless of the fact that I really need a CGM now.
Jim