Hi, While brousing, your remarks caught my attention. I live in Mich. and have Medicare Plus Blue insurance. Have been turned down and am presently appealing. Waiting to hear but I can’t be to optimistic based on what I have heard from people who’s job it is to know.
Am very much a candidate in every way. Type 1 for 56 years. Hyo. Unaware. 6 shots per day, etc. etc.
This product would be a Godsend, for presently I am experiencing terrible rebound effect sleep time hypos. If it wasn’t for my terrific wife…,I would have died years ago. This is ironic, as I keep my glucose under very good control.
My extreme highs and extreme lows average out to an excellent 5.9 A1c. This “great” number is unreliable as to how your diabetes is doing. How wonderful being monitored 24/7 would be. Not only for me, but for my wife as well.
Needed to talk, relieve my anxiousness.
If you have any possible helpful info., or would comment on your progress, I would be grateful.
Regards,
Jim
I learned what my glucose was REALLY doing an hour after eating. (without sticking myself 10x a day)
I learned though I had reduced my carbs to lower than the ADA diet, I still needed to reduce more to keep from going way high after meals.
I learned the snacks I could get away with were no more than 5 grams at a time, not 15 grams.
I learned that for my weight, 105 lbs., I need 1.5 grams to raise my glucose 10 mg/dL.
I learned what happened when I treated hypoglycemia I doing the 15 grams glucose - 15 minutes - test = why it always put me up in the high hundreds. For me, 6 grams will do, thank you.
I learned how to go to sleep at 95 and wake up at 95 the next morning.
I learned how to even myself out, no lows below 65 and few highs, except after I’ve been given cortisone injections for my pseudogout knee.
I got my awareness back because I could treat myself ensuring I was using small numbers which didn’t make me dive.
I moved from the “brittle” diabetic I was tagged with to a well controlled 5.5 A1c in one year. Before, I had been 7 with as many lows as highs and that’s what they averaged to.
Problem is, no one is paying for it except my personal $. So no matter, progress is in the eye of the beholder and I’m happy.
Hang in there. It might happen in our lifetimes.
I also live in michigan. Check the state of michigan’s web site in their health section. I don’t know what you qualify for, but there are many different insurance options available depending on your need. If you qualify, I’d start checking to see if those other plans will cover the CGM.
Worse case senario, keep bitching. Appeal every denial, call them 10 times a day, write them letters, write the local and state government letters.
In the mean time, I’d talk to your endo about the night time lows. sounds like your insulin needs to be decreased.
Thanks Sarah, good stuff.
Insurance, maybe just w/Medicare, prices and companies available, are determined by the county in which you live. My county, Oakland, doesn’t offer very many.
This is the only reason I still pay for BC/BC as a rider with my Medicare. I’ve heard no other company is tougher to amend an appeal.
My appeal was mailed two weeks ago yesterday. I hadn’t thought much about hounding them over the phone, but I can be good at this. Do you think the first call is a bit to soon? Any idea how long it usually takes to get their decision?
Thanks again.
Thanks Leona,
Very good list of arguments I can use during my appeal as I pester them on the phone. I printed your remarks.
If you don’t mind, How much do you spend per year on your CGM and equipment? I have heaed $4000 for the sensors alone. Is this about right?
Please share with me some of your insight during my period of appeal. My wife and I will be most grateful.
Thanks again.
Jim
Jim,
$253.40 per month - Dexcom; 4 sensors a month. I think due to 5 week months you count 13 months in a year and you’ll have 3294.20. My initial cost was 714.90. There will be more costs during the coming year as transmitter and receiver will no doubt need battery or something. So far, so good. Started 2/1/08.
From my records: total diabetes supplies last year 2008 were 4690.79. The rest of those dollars went to syringes, test strips, and lancets. Humalog and Lantus were not diabetes supplies but listed in my records as drugs and are not reflected here.
I listed those for me, too. When I return from being a snowbird down south I’ll have to give what I learned to an endo! So I’ll reuse the list in a bit more direct format, one he can pass on to his CDE.
Best wishes, Leona
Thank you.
I also use Lantus and Humalog.
When hounding, have immediacy of need spelled out so you can tick it off. The first thing being tackled, the second thing, etc. Know exactly why the first thing isn’t getting accomplished without a monitor.
I tried calling BC/BS today, got to the appeals and claims dept., and was told by a nasty sounding person that nobody EVER gets to talk with a decision maker, but she would write down any questions I had. So…after me reciting several concerns, she coldly tells me thay will contact me if anything is needed from me.
I will try again, I assure you. I have been challenged.
Thanks much for your helpful words, Leona.
Please keep in touch.
Jim