This group offers those interested in advocacy efforts for CGM reimbursement a common hub to share ideas, opportunities and promote common efforts.
I'm a T2 for 20 years, pumping for 7. I have 9 basal rates to null out dawn phenomenon. A cgms is needed to keep those rates accurate, as I have to change them seasonally.
I am an advocate for my husband who has been a Type 1 diabetic with hypoglycemia and hyperglycemia unawareness for approximately 15 years. He went onto Medicare in June of 2012 and soon after needed replacement of his CGM. This was denied because it's considered a "precautionary" device. We appealed the decision and just finished Level 3 of the appeals process. We lost this appeal last week and are now going to go through Level 4 which is the Medicare Appeals Council. I am interested in being in touch with anyone who has had the same problem.
I am a Type 1 diabetic since 1988. I have been using the Dexcom pump since January 2010, and it has made a huge improvement in my blood sugar control, while minimizing hypoglycemic episodes. I will be on Medicare next year, and fear losing insurance coverage of my CGM under my current insurance. If that happens, my quality of life will change dramatically.
I am also concerned about the future for my 43 year old Type 1 son, who relies on his Medtronic CGM to keep him safe.
I had read somewhere recently that there is a new bill proposed in congress on the CGMS/Medicare issue. I believe it was introduced by a House representative from New Hampshire. (H.R. 3710) I myself will not be eligible for medicare for some time, but I know how important the use of CGMS has become in helping with control of my T1... The best thing to do here is to contact your local representative and "Strongly Persuade" them to get on board with H.R.3710...always remember they work for YOU.
http://beta.congress.gov/bill/113th-congress/house-bill/3710
34 yrs old, T2 for 7 years. Currently MDI, just awaiting insurance $ to come through and should be Pumping via Medtronic Veo within a month or two! My health benefits from work are from 2 difference companies. One for my medications and the other for everything else. So far 1 of the 2 insurances companies have denied my CGM request for coverage....fingers crossed on the other. I see CGM as a possible game changer in the hopes of analyzing my diabetes, my body, and learning how to better control it and ensure I have a longer and better quality of life. I live in Canada btw.
71 yrs old, T-1 for 44 years, pumper for 30 years never having any awareness of extreme highs and lows. Medicare will pay for 7 days of CGM thru the hospital for adjustment of medication but will not pay for CGMs for me to use at home. Senseless as would cost a lot less than so many ER visits and eye and kidney problems. Let’s all advocate for each other!
There's a petition about this circulating right now. Check it out!
Just got this from Medicare:
Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) Meetings
Posted Request for Nominations for Members
http://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/Downloads/nom2014.pdf
I'm thinking we should nominate someone!
Dave, re: people with diabetes on medicare. I guess you cold do a best guess. Take the number of people eligible (from the US census age reports), apply the basic percentage of Americans who have D (probably available from the ADA) and then figure between 5-10% as having type 1.