hey guys ive been looking at cgms for awhile now, and ive been wanting the dexcom gms. but I JUST got my pump(omnipod) 2 months ago and dont know if im asking for to much? I went through hell and back just to get my pump and I know almost EVERYONE gets denied the first time they try to get ther CGMS but whats your opinion? should I try getting one?
I got my Cozmo pump in July when I went on my husband’s new insurance and just got my Freestyle Navigator CGMS this month (put in Rx’s at the same time). I say go for it! They said yes to me.
My insurance needed a whole month of documented blood sugars before they would approve a CGMS. I test 10-12 times per day so was able to send them 47 pages of logs. So have that ready for them. Document, document, document! AND they needed to see that I had recurrent episodes of blood sugars below 50. I average about 6 or 7 episodes below 50 per month and that was “recurrent” enough for my insurance.
One of the keys to getting approved is to find out the exact warm-blooded human being at your insurance company that is in charge of denying your claim. Then the doctor can address that person directly. Trust me, it’s helpful - though hard to pin down.
I think you should go for it!!! Just like Melissa said they’ll need documentation to justify your need for the CGM—hypo’s and hyper’s are what they look for.
If your insurance company tells you NO! Keep fighting and they’ll cave in. Good luck and keep us posted.