I’m in process of my 2ND appeal. The general public will be informed of the CGM and a notable personality will push for acceptance before the CGM is widely accepted by Insurance Co’s.
They must be convinced paying for this hardware is, in the long run, profitable.
A press release submitted to your local paper is always a wecome thing, to these papers, who have many days of problems filling space. Must simply contact a journalist (s) first and talk him/her into letting you send your press release to their desk. Trust me, no big deal.
Smile
I don’t have one but my mom-in-law does and her medicare paid 100%.
Responded in wrong place, I think. I have Medicare with Blue Cross as My carrier. My Insurance is called Medicare Plus Blue. I am now on my 2nd appeal regarding CGM denial. Was told to appeal to BC/BS here in Mich. Their 1st appeal denial simply said CGM isn’t covered by Medicare so therefore they can’t pay. Please tell me more. Does your Mom-in-law have a carrier? All info. on this might be a great help.
Thanks
Oxford covered it pretty much 100%, all we had was a $15 copay! And a $15 copay every three months for supplies. Thats it.
Oh, and I have the Dexcom! 
Do you have to have a pump to use CGMS?
no
Blue Cross Blue Shield of IL. The sensor code (A9276) is now a covered item, BUT the transmitter and receiver codes (A9277 and A9278) are not. I personally believe that the sensors being covered is a huge deal as it paves the way for the entire CGMS to be approved - even if on an appeal. I had mine approved on the 2nd appeal. I did use the sensor code approval in my appeal.
Medco for minimed sensors and transmitters. $40 copay for 3 months supply and $40 for the transmitter as I seem to remember. BCBS of Il said it would not be covered but I found it (sensors and the starter kit) in my drug list (formulary) with Medco just like my infusion sets. Just had a prescription sent in and then it was sent to me.
Coventry Healthcare of Kansas… after a long, drawn out battle
Oxford Health Plans
a UNITED Healthcare Company
Oxford Exclusive Plan/Freedom Network
RxGrp: OXFRDHP
United Healthcare
Choice Plus Network
Available New York north of Ulster County
and all other states except Connecticut and New Jersey
Hi, we are in Westchester County, NY. I typed out the whole card for you (without personal info). It is high time someone kept track of all insurance (and what plans in the insurance) covers cgms. Thank you!
P.S. They did deny; we appealed; denied again; we got it on our second appeal; First, we have written records (using her endo’s logbook sheet) and have kept them since diagnosis. Every three to four hours round the clock; food, exercise written in. Everything. Second, the records are on our pump. We test 15 times a day now.
P.P.S. It is difficult for her to wear the Minimed cgms, although she needs it desperately, because of that huge introducer needle, which has caused problems for us before. If MM does not reduce the size of their needle shortly, we will go over to Dexcom. We love the MM pump, as we feel it is so reliable, so won’t switch the pump.
I just received my 3rd replacement MM 722 pump with CGM covered 100% by Healthnet. No copays for sensors either. I’ve been on the pump for many years and have had diabetes for 48 yrs. I’m very thankful about the inurance coverage!!
No: both Dexcom and Abbott operate independently from any pumps, and Minimed makes an alternate model (the “Guardian”) which runs like Dexcom and Abbott, with no pump dependecy.
Oxford Insurance in CT. But only after the JDRF study could be used as an appeal weapon! 
I have United Healthcare and my CGMS was covered at 100% (so far). I am not sure if my special circumstances helped in that or not. I am hypo unaware, and my last a1-c was 4.6. That could have played a part in the 100% coverage decision. Originally I thought it was only going to be covered at 100%, but after medtronic verified my insurance they said it was covered at 100%.
Any body ever get Medicare to cover CGM?
Tufts. They covered me on my 2nd attempt too.
Highmark BlueShield in PA, 100% coverage
carefirst blue cross blue shield maryland covered me
TriCare Prime 100% for everyone using the MiniMed CGMS, at least in my region (Texas)
I was 100% covered for CGM by Tricare. I’m active duty with the U.S. Navy, and there were no issues.