So I have to have a 3-day test with an iPro before my insurance will approve a CGM. (They approved my pump, but required me to use it for 6 months before getting a CGM.)
Does anyone have any experience with this? Should I intentionally “fail” the test?? (I.e., anti-flatline…)
I don’t think it matters. It’s not like they do anything to check your responses to the thing or anything like that. It mystified me that I had the thing plugged in and got zero data and zero feedback. I exclaimed “yikes, that looks horrible” when I saw the (much more detailed than we get…) graph on the chart and the MM SalesNurse said “that’s actually really good…” but that was all I got out of it. Zip from the doctor, zip from MM and, of course, zip from BlueCross.
Did you contact your insurance to see if they do actually require this? To see what their criteria is for approval of a CGM? My endo made me do a 5 day iPro stint, claiming that my BCBS required it to get a CGM, and they really didn’t. I felt the same way AR did as far as ME not getting any feedback from it while I was wearing it. It was completely pointless for me. Find out what your insurance requires, and then you’ll know what you need to do. My insurance doesn’t actually require this, but my doc claimed they did - that they wanted to see a pattern of lows of 50 or under, to prove that I’m hypo unaware and need a CGM. I went along with it just to get doc to leave me alone and get the ball rolling on the CGM, but I’ve decided I’m done with her wasting my gas & putting mileson my already aging car…I always contact my insurance to see what their pre-reqs are for approving things…from now on I stand up to the doc and ask her to give me proof that the ins. told her they require whatever it is she’s demanding I do before I get what I want.
BC/BS required documentation that I had lows below 50. They accepted my logs as proof. No fooling aroud with an Ipro though, tg.
Yeah, fair enough, but it’s MINIMED who’s telling me what my insurance requires… and administering the test for me. I figure they wouldn’t put me through non-required hoops – they’re the ones who want the money.
Durn thing is all covered in dried blood, and I still got 3 days left!
Oh – interesting tidbit from the Medtronic saleswoman – she says they have combined pump/cgm infusion sets in the works. Already at the FDA; they hope for approval in 6-12 months. That would be cool, eh?
So how did it go?
Really? If this is true, it would be a good reason to purchase a MM pump.
Haven’t heard word one about it.
The problem I see: Most people use their sensor for more than 3 days and in fact most feel they get the best results after the initial 3 days. This is not even to mention the money saved by using them longer. With an infusion set attached you would have to change the sensor every three days as well whether you wanted to or not.
This must be a closely guarded secret to make it to the FDA without seeing anything about it. I have seen info about their new Enlite sensor which is currently seeking FDA approval but as far as I know is NOT attached to an actual infusion set.
Hope the IPro “test” went well.
That wouldn’t be ideal…since infusion sites have to be changed every 2-3 days and I can get at least 7 out of a sensor. In fact it takes a day or so for the sensor to “settle” in for me and get great numbers.
Meh – I got a decline letter from my insurance while I was still wearing the thing. They say my control is too good. And who knows what the ipro will show, but as far as my fingerpricks went, it was one of the best 3 day stretches I’ve had. Oh well.