I’m not sure if many are aware but the CGM supplies we need (Sensors/Transmitters) can be covered under the prescription portion of your insurance. Several years ago I was sitting with my CDE and she started all the BS paperwork that needs to be submitted to the insurance company for denial or approval usually requiring frequent lows, hospital stays…etc. I cam across Foundation Care Pharmacy (I think they are located in MO) who just require a current Rx. Once I found this out, I informed my CDE and she was in disbelief. It speeds up the process for the patient and makes it a lot easier for the doctors/CDE’s who fill out all the paperwork for the medical portion. I don’t work for Foundation Care nor know anyone that works there. Just trying to help out fellow diabetics who know its a pain in the butt trying to get these supplies. They can run a test claim to see if your supplies are covered as I just did with my Dexcom G5.
I get all of my Dexcom supplies from a specialized Walgreens pharmacy now… it’s not my regular local one, but it’s only about 10 minutes from work so I don’t mind going out the way to get them
Dexcom also has a current RX offer out right now where you can basically get everything to get started on G5 for $0… and then your monthly supplies are capped at $40 for 6 months… if you call them up and ask about it they can send you a card
Here’s proof, it just shows up with the rest of my Walgreens stuff…
“Can” be covered under Rx, but only IF your insurance allows it. I have a friend who not only gets all Dexcom supplies (including the system) but also pumps & supplies covered under Rx. I admit to being extremely jealous of her $75 copay for the Ping. It made my $1800 copay/coinsurance hurt all that much more. I have yet to have a plan that covers under anything but DME.
Several years ago, when I had a PPO plan, I could get my pump, pump supplies, dexcom and dexcom supplies all covered under Pharmacy, with copay for 90 day supply. And yes, I even got my pump for the copay. The PPO plan covered multiple diabetic supply items as a ‘kit’, and could be combined into one copay. It was great while it lasted, and I also used Foundation Care, since they could bill as pharmacy. They were friendly and provided great service.
But then my company changed plans, and under my new plan, they are all covered as DME. The premiums are much lower, so depends on how you do the numbers, but for me total OOP costs are about the same, but it sure felt cheaper when I paid the co-pay.
