Seeing how Kerri decided to take the CGM plunge today and how many other members (myself included) have shown an interest in CGM, I just opened a new section in the forum for CGM-related discussions.
Fire away…
Kerri is posting on her Twitter page her experience with the Dexcom today.
Check it out: http://twitter.com/sixuntilme
I truly hope CGM becomes standard and accepted and paid for by insurance really soon. I am not enough of a “model patient” or assertive enough to be a frontrunner in this, but I’m sure going to get one as soon as it’s commonplace. And luckily, I don’t have hyoglycemic unawareness. My Minimed pump is all set to work with one so…hopefully one day soon. In the meantime, I’ll be interested in reading about everyone’s experiences.
I’m done with the school year, so one of my goals is to get insurance/Minimed to cover a CGMS for me. It is a necessity! I am an excellent candidate, 30 years of compliance, occasional boughts of not-knowin I’m lowin’, and getting primed for pregnancy. So far, I’ve been unsuccessful at lowering my A1C to acceptable baby-making range with my pumpin and feel strongly that CGM will behoove that ‘someday-soon’ effort. Why I am not allowed this yet? I’m blessed with great insurance (thanks Mikey) and still, I’m supposed to fork over “how much?#@!” out of pocket and punch through numerous stressful hoops to even … oh, I blather. I need one. Tell me how.
A friend let me try her CGM which hooked me completely - 2 weeks later I ordered my Dexcom, i have had it 1 months and have gotten 14 days out of each sensor, but notice that i get some really off readings after day 11 - but not bad enough to start a new $35 (soon to be $60) dollar sensor.
Because I am so fantastic, today I am letting another diabetic friend take possession of Dex for a week(or as long as she can get the sensor to read accurately for her).
Although it is first Generation - if this is as good as it gets - it is good enough for me.
I have found a few articles about the Real Time CGMS on Diabetesjournals, but they are quite involved.
I want to print off an article to send with my letter of medical necessity to my insurance company for this device.
Has anyone found a good article about the system explaining its usefulness over our current finger sticking method?
This is what I found, but it seems way to technical somehow, but do I really care?
These are the 2 sample letters Dexcom gives to have your doctor complete - i filled it all out and sent it to my doctor to sign. Just filed - no word on approval or denial yet.
9254-SampleDEX.doc (45.5 KB)
9255-SampleDEX2.doc (28.5 KB)
So, it sounds like I may be able to get a MiniMed CGMS and sensors covered by my insurance after all! Not sure how long that process will take, but I had a visit with my endo at the Barbara Davis Center today (everything’s looking good) and signed up for their CGM class in a couple weeks. So regardless, I’ll get to play with a loaner Dexcom for a week or two and only have to pay for the sensors. I am psyched!
I am jealous. 
Manny
I’ve also created a Group for CGM users. All are welcome.
My son got it after 15 lows with seizures.( The endo group failed to dx or suspect another condition; the neuro said he shoiuld have been referred after 1 or 2. They only partially redeemed themselves after giving the rx for the RT Guardian).So we got the new Minimed pump, and the sensors. He does not like the needle on the sensor. It is mich larger, and very hard to insert. He wore it alot, and got a month’s worth of numbers, turned it over to the new endo, who never interpreted the numbers to adjust basals etc. They said they had not been trained on it yet. I said they are numbers( 205 a day)!. That is about 200 more numbers than you get on average. Because of his history, Ins is covering it. We also have some good diabetes insurance.
I have my letter done and a letter from endo and documentation off the internet.
I contacted my insurance company yesterday questioning who I should send this info. to, since Medtronic never contacted the insurance and therefore there is no denial claim set up. I am not happy with Medtronic about that, but they told me that is their process, but I since have found out that Aetna reviews on a case by case basis, but if Medtronic never submits how can there be a case to review.
My response from my insurance was to have the provider fax a pre-determination of benefits with all supporting documentation and Medtronic does not do that, ahhhh, one big vicious circle. I am contacting Molly at MM on Monday to ask her now what??? but I will be faxing my stuff on Monday myself to see what happens.
Karen and all,
I’m in a similar stage of requesting a CGM. Back in March or so, I had my endo send a ‘letter of medical necessity’ to Minimed. They denied it. Now I have the paper work to appeal that decision. Thank you so much for finding those academic articles. What a great help. I’m off to fill in the paperwork and hope the ‘case-by-case’ includes me. I think I’ve heard them right (I have Regence BC/BS) when they suggest that if I pay the $999 upfront, they may reimburse me afterwards. I wouldn’t mind, if only I had the dough and I was sure they really would reimburse me. Hmmm, perseverence is what is needed here. How can I make this fun?
Here is more help that was sent to me from someone off another website.
9253-CGMSClaimsHelp_Generic.zip (5.11 MB)
Well I faxed my letter, my doctor’s letter, and documentation about the CGMS to my insurance today. 21 pages total. Keep your fingers crossed.
I’ve used the MInimed sensors/transmitter since April. So far, I’ve made adjustments with the help of my pump trainer, something my endo knows about. I can upload all the data to the Minimed Carelink website, then my pump trainer can look at the numbers and make suggestions. Minimed customer service (their 1-800-minimed line) has also looked at my data this way to help with a problem of too many"lost trasmitter" situations.
When I see my endo every 3 months, I bring him the graph of where my numbers have been. It easy for him to see how I’m doing. Good luck to you and your son, Kelly.
I will get my senors next week. My insurance just approved it. I hope the senor will help me with exercise and other things. My last a1c was very poor. Mostly my training for the 1/2 marathon cause my high a1c . Also it could help like mystery highs and lows. How does it feel to have both the infusion set and the sensor in you? How do most people like it.
keep on them Karen … you will have it in no time . I am amazed at what my bs does .
Thanks Tracy I will. I already emailed them to see if they got the fax and they have not responded. Monday will be my phone call.
Do you feel any better Tracy, knowing what your bgs is doing and being able to adjust quicker to what is happening? Do you think it could ever lead to diabetic overload?
Have not heard from my insurance as yet, not even a reply as to whether they got my fax or not, grrrr!!!
I emailed them again today.
Karen