Which insurance covered your CGM

Can you please list here which insurance company covered your CGM and under what terms?

Anthem BCBS (Virginia based). I’m not sure of all the terms yet. Was just notified Friday. It’s covered at my 90/10 copay, but I’m not sure about the allowed frequency or quantity of a sensor order.

Horizon BCBS of NJ covered it for several months, but then they were jerks and stopped. I’m still waiting to hear if they’ve come to their senses and decided to cover it again.

Gina, I just won a 2nd Level Appeal reversal from Aetna PPO out of Texas from my husband’s employer Lockheed Martin!

Empire Blue Cross Blue Shield, NYC. Covered 100%. No denial, no appeals, instant authorization when Minimed contacted them. They also paid for a new pump even though my 715 was still under warranty.

BCBS of Nevada–but only with employer intervention& threat of lawsuit.

Anthem BCBS (Virginia based) and Carefirst (another Blue Cross) based in VA covered them. Between the 2 Ihad NO copay.

In Ohio, United Health Care covers them. They fall under DME (durable medical equipment) as upposed to major medical like my supplies. My DME cap is $2,500 so my first year will cover the transmitter and about 9 months worth of supplies. Year two should cover all 12 months since I’ll already have the transmitter. Obviously insurance plans differ and this is just my group but it is covered.

CIGNA 100% coverage. Sweet! Took me a while to actually get it approved. They said I was one of the first in CIGNA to actually traverse the process. Hopefully this will open the flood gates.

Mamsi/United Health Care Optimum Choice I have a $1000 dollar deductable which i have met between my infusion sets and medication most of my CGm was paid for and I was only responsible for a couple hundred bucks. Now the sensors are paid for 100% along with my infusion sets.

Tricare (Military insurance managed by Humana) they covered 100% with a year of appels then the General of Ft. Sam Houston,TX theating them. But they did cover 100%

Today I am due to receive the Minimed CGMS it’s taken me a year to get Regence BCBS of Oregon to cover. I had to go through with all three appeal stages. The independent review organization finally overturned the previous denials!! Now I’m ready for the work to make the technology work to MY advantage!!

See my page and blog to find out more about my struggle and WIN… http://tudiabetes.com/profile/davissimo

Please contact me if you’d like to hear more details.


United Healthcare (Choice plan) covered my original CGM from minimed last year with only a letter of necessity and rx. When I ordered more sensors about 2 months ago, they originally denied the coverage on the basis that the sensors are “disposable” and not “durable”. But I complained (informally) and they finally sent me a letter that they reconsidered the charge and are covering them.

Aetna PPO also-- hypo unaware. Getting in network coverage - 90/10. Aetna’s policy has changed for those hypo-unaware but is still case by case. Went thru pre-auth. Dexcom handled. My endo called the Aetna dr once.

BCBS of TN, but they are under review of their policy right now and may stop paying for my sensors. There was no fight at the beginning, but there may be one after this month. Sigh.
At the time I recieved it, it was a case by case basis and if you met the criteria. I did meet it and there were no problems. I applied in January and had it by February.
If they stop paying for the sensors I may have financial issues to pay for them though. It might be a problem. But I am praying for a good result of the review.

I was at the American Diabetes convention in Pittsburgh last week and saw my rep from Medtronics and she told me that as of October 1, 2008 Highmark Blue Cross will be covering me for the sensors. I jumped for joy…what a relief financially.

BCBS of Nevada–durable medical

Our company is going to switch insurance companies. We will be going to ODS, mot sure what that stands for yet. They are a west coast company, Oregon I think. Anyone familier with them? Do they cover CBGM?

I just got my CGM through Medtronic covered by United Healthcare. Medtronic actually that told me that my plan with United would cover it, and they did.

Blue Cross Blue Shield of Texas…! 80% insurance 20 percent copay once i met my thousand dollar deductible.