Medicare pump rules different than what I was told previous to today

Thanks Jason. It’s all so frustrating.

Yup, frustratingly Stoopid. I didn’t quote your post as an attack. I thought you made a great point and I wanted to add to it. Sorry if it came across negatively. I like @Dave44, he and I don’t agree on some things but he’s never been a jerk to me. He was excited about his pump and having a 12 month grace period to try it out. I hate that this happened not only to him but countless others we’ll never hear from. We can’t fight city hall, but we sure as hell can b@tch about them.

I think we can fight city hall and I think we should. I would like to see a nationwide march protesting the unfairness of it all.

Disagreeing is ok. It’s a way we learn about each other’s different point of view.

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In a prior discussion, @Laddie said this

However, when you get a pump under Medicare, the first year is considered a lease and after that it belongs to me for the next 4 years. Pumps purchased under Medicare are only replaced every 5 years unlike 4 years for most private insurance. But the lease year is more flexible than private insurance and I know people who have been able to change pumps several months into the “lease.”

@dave44 Sorry it may not work out in your case.
Maybe each supplier makes the rules of lease.

Are you having 2nd thoughts on going for T-slim?

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I might be behind on this stuff. I thought that medicare didn’t do Medtronic sensors. There were FDA concerns last I heard. Maybe that doesn’t apply to the 670g? Maybe that has a different sensor?

I have never even heard of a refurbished insulin pump. That’s peculiar.

That is still correct. But many use medtronic pump with dexcom cgms, without integration.

Medtronic needs to file with FDA, FDA is not holdup.

Edit to add: 670 G3 is FDA approved, but medicare does not cover G3 sensors because there is additional FDA approval for Guardian 3 sensors to not require BG testing. (There is a new post saying Medtronic has filed with FDA)

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FDA preventing filing. The sensors were declared inadequate in reaching minimum standards. But, stuff must have changed if medicare is allow 670g, right? Or, is that a totally different sensor type? Or, is it like the cell phone thing where Medicare just relented and gave the go ahead despite a lack of FDA filing? They have been doing that, too.

The 670 uses a different sensor. @DrBB says the accuracy is along the same lines as the Dexcom g5. What cellphone thing?

Ahhh, that makes sense. That seems correct because I think they are doing FDA trials for new sensor tech. I think they have some in trial that are supposed to be more like G6, even.

Oh, you know the thing where FDA was super mad about people on Medicare using cell phone apps to monitor BG? They made the argument that cell phones were not formal medical devices that could not possibly be sent through FDA and if they caught people using the cell phone app they would withhold funding. That was a thing about a year or so ago. But, then they changed their policy and said people on Medicare could use the app because people complained that their family members didn’t have access to share functionality and it posed a risk to their physical safety. It was pretty interesting because there was a standoff between arguments surrounding physical safety VS application/computer security. Physical safety won.

I can’t figure out why Medicare is paying for the 670 but doesn’t cover the sensors. Why pay for a more expensive pump when most of the patients don’t have access to the sensors. The 630 would be a better alternative financially, most Medicare patients are using Dexcom with their Medtronic pumps.

I remember that fiasco. Another rule put on Medicare patients and nobody else. They also didn’t allow the Dex to be paired with an insulin pump. Dexcom fought them hard on those rules. I’m glad they stood up for their patients.

Those according to our pump nurse won’t work as well as the G3.

My husband explained this to me as to how they will not work as well. I don’t understand it all but he does.

For him the G3 Sensors would work the best with his 670G pump.

That does make sense to me.

Thankyou.

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I agree. their usage of the term “rental” now seems more disingenuous than before my convo with CCS Medical yesterday.

Yes. For starters I’m already used to wearing a receiver along with a pump so not having integration between a CGM and a pump isn’t a show-stopper for me. ALso, I don’t trust ANY sensor to be accurate 100% of the time. I don’t want a false low to shut off my insulin in the middle of the night, for example. Even my trusty G5 COULD read falsely low if it were pressed on too long and hard, which I try to avoid by my usual sleep positions.
Second of all, I have issues with certain aspects of the Tandem pumps which I’ll not repeat here for the umpteeth time.

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Perhaps because they anticipate future FDA coverage of the Medtronic sensors? Just a WAG.

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Trying to suppress the urge to poke …

Trying …

:crazy_face:

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Some people report the newest iteration of the Medtronic cgm system is giving them as good results as the current Dexcom G6 cgm system.

Others would disagree and say the Dexcom G6 is still better then the Medtronic newest iteration cgm.

It would be difficult to find people with experience with both systems that state that Medtronic cgm is actually better than the Dexcom cgm.

The only rational explanation I can think of (in regards to the comment above) is that the Medtronic cgm will integrate with the Medtronic pump. So for somebody who is using the Medtronic pump they may find benefits to also using the Medtronic cgm integrated particularly if they want to take advantage of any of the Medtronic pump algorithms that involve automated insulin decision making.

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I believe you are exactly right and well said.

Nope, it will just create arguments from those who don’t share the same requirements that I have in a pump. :slight_smile: (Nice try though)

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Their algorithm for the low suspend is awesome. The loop is going to be so much simpler than the 670. I see nothing wrong with using the Dex and 670. If and when the Medtronic G3 sensors are covered by Medicare, I think you should try them out for a month, if you don’t like them go back to Dexcom.

Or just trying to get sales numbers as high as possible?