Personal letter to insurance for pump and CGMS appeal

Hi all!
I need some advice. I am writing a letter to my insurance company for my final appeal with getting an insulin pump and continuous glucose monitor (Minimed). I am at a total loss as to what to say and what not to say.

My background: Insurance is denying coverage because I have a normal c-peptide and no antibodies. I have Cystic Fibrosis related Diabetes which is not Type 1 or Type 2, but I take Lantus and Humalog, sometimes up to 8 shots a day because of my insane nutrition needs (super high calorie). I eat almost continuously. I am having a hard time controlling my bg levels because of it. High bgs causes complications with my CF, mainly due to dehydration. I have been denied coverage twice now (primarily because of the c-peptides and lack of antibodies) and only have one chance left.

My case manager suggested I add a personal letter to the reviewer for more impact and to show I have a genuine interest in getting the equipment. What on earth do I say in this letter?
Thanks for your help! :slight_smile:

as a fellow “Other” i commend you for going for the pump and CGMS. you are breaking new ground for us other “Others”. I don’t know what to say, but wanted to give you moral support in your journey.

Also include a statement from your doctor and who ever else is on your Medical Team about your diabetes about your need for an insulin pump and CGMS. Tell them why you want it, and explain to them how it will help you if you get the pump. I fought with my insurance company for over a year to get my pump as well, but in the end my c-peptide levels met the requirement. It turns out I am not a type 2 but I am type 1.5. Consider including in there a copy of your medical records showing where you take that many shots a day and how much you take and consider enclosing a record of your blood sugars in there as well. Talk to your Minimed rep as well and get their advice. CCS Medical who works with Minimed helped me with my fight to get my pump.

Yea, my doc has a HUUUUGE file she is sending in. Including my bg charts, daily details and such. Also, every email we have sent back and forth she is including. She is on top of it, but I need a personal punch and I am having writers block! :slight_smile:

Thanks for the advice.