I am stupid excited about it. I didn’t even get a chance to send in my appeal, apparently my endo did a peer-to-peer and she got it approved.
I’m really happy as I’ve noticed being back on campus and having some teaching duties again is making my sugars go low. That and I’m fine when I leave campus, but my blood sugar gets low by the time I get home (I have a 40 minute commute). I’ve had some middle of the night lows too, especially after a crazy day.
Thanks for reading this… I had to share with people who care!
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Congrats!
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Way to go.
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You are perfectly justified in feeling “stupid excited about it”; it truly is a game-changer! I would give up my daughter’s pump before I’d give up her Dexcom!
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++1
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Welcome to a new way of living with diabetes! Do yourself a big favor and use the data stream for your benefit. Don’t be afraid to alter the timing and dose of your insulin. Do the experiment, observe, change something, repeat. Diabetes is dynamic. There’s no reason for you to stay in a treatment rut. The CGM does change this game. It’s an eye-opener!
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Yes, yes it does, and yes it is!
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yay!!!
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Congrats-What grounds were you originally denied? I am going through the now you are 65 years of age. No more Dexcom thanks to Medicare (primary) & GHI (Secondary). I am in the process of starting my appeal.
I wouldn’t give up either - both are essential. The pump gives you a tool to control your insulin dosage but you really need the ongoing information about glucose levels that you get from the CGM to use that tool most effectively. Without it you are basically flying blind (OK you are allowed intermittent peeks from fingersticks but I wouldn’t want to fly in an aeroplane where the pilot was only able to look at his/her instruments for one minute an hour).
Joel
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I have BCBS-NE Student Blue through my graduate study. They denied it originally as investigative (experimental). My Endo did a peer review, which got it approved, however, only through December. I am a little worried that when the new plan year starts in August that they will begin to deny it again (it had a caveat about changes in the plan).
My supply company and I were working on an appeal letter when it went through, but I was writing it from a very academic point-of-view, using the research showing better outcomes with CGM use, as well as the court decisions finding that Medicare should be covering CGM in Type 1.
I’ve only had the Dex on for a couple days, but I’m partial to my tSlim (I had a lot of lows on MDI). I am having a lot of trouble getting my Dex to track anywhere near my meter. I almost wonder if my Aviva meter is off, rather than Dex.
This is EXACTLY what happened to me when it was run through DME instead of Pharmacy benefits, pretty much the same wording even. I have BCBS-IL. When I called Pumps It, Inc. to see about cash pricing they told me that the company I’d originally used shouldn’t have told me it could be run through DME or Pharmacy, ONLY Pharmacy. I ended up NOT having to do an appeal at all. Pumps It, Inc. got it to go through, no problem.
It could be your Aviva. Have you checked your test strips with control solution? Are you using your very best finger-stick protocols (washing hands, not mashing fingers, etc?) They are allowed to have a +/-20% accuracy. I did a fingerstick yesterday while my Dexcom was reading in the 90s and my Accu-Chek Nano said I was at 156. I’d had a somewhat carb-heavy breakfast and my sensor is way past 7 days, so I just assumed my Nano was right and correction-bolused. Right after I bolused, I decided to double check. I really should have double checked BEFORE I bolused. The second finger stick was only 2 points off from my Dexcom, which had been reading pretty tightly to my Nano for the past week.
Keep in mind that interstitial fluid lags behind actual blood sugar as well by about 10-15 minutes or so sometimes, so if you’ve eaten or exercised recently and do a finger stick your blood glucose reading may be very different from your Dexcom reading.
Certain things like taking Tylenol, or taking a very hot bath or using a hot tub can also create weird Dexcom readings.
After the first 10 to 24 hours into a new sensor, I trust my daughter’s Dexcom much more than I trust her PDM’s Freestyle meter…
I lost coverage for my Dexcom when I turned 65 four and a half years ago and have been self funding my CGM since then. Coincidentally, I have the same insurance you have. Let me know how you do on your appeal.
Good luck.
Dave15,
I am in an appeal with my insurance and not very optimistic that they will cover a CGM. I need to get one soon to practice with it before a trip I have in mind. I am clueless about self funding…where do you buy a dexcom and supplies. Can you get them OTC or do you have to go thru a pharmacy, direct to Dexcom, Amazon, etc? Thanks
You need a prescription in order to purchase a Dexcom system. Have your endo or PCP write you a rx. Then call the nice folks at Dexcom, and they’ll get you all set up.
You’re going to love it! I’ve said it before and I’ll say it again: Dexcom is a game-changer.
Actually I recommend a better course of action is to call Dexcom and let them work it. Even if your insurance doesn’t cover the Dexcom you should at least have Dexcom file it and you may find that you get a substantially lower price when filed through insurance. Unfortunately the system is rigged against us patients. Their is the real (inflated) price that is offered to insurers and then there is the fake price charged to patients off the street (I have found the difference can be as much as 1000%).
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Medicare has approved the Dexcom G5 for us on Medicare. I contacted Dexcom and they confirmed and gave me info on Liberty Medical who is their Medicare approved distributor in my region. I contacted them and we filed and they told me I am approved, Medicare will cover 80% and I hope GHI, my secondary, will cover the other 20%. I have a call into GHI. I will keep everyone posted.
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