CGMS: Denied

Gina at Diabetes TalkFest has declared July 1st as CGMS Denial Day. Diabetics all over the web are posting their struggles with private insurance coverage for their CGMS.

As posted a few days ago, my coverage has been pending, and pending, and pending, and pending.... (get the picture?)
So I have not ordered any new sensors since my initial order that included 5 sensors.

A CGMS system can show me 1 hour, 3 hour, and 9 hour blood sugar trends, showing me a new result every 5 minutes. It can also beep when I start to get too high or too low, alerting me to correct the problem right away.

My latest A1c (3-6 month average of blood sugar levels... normal is considered between 4-6%) was 6.9% this is fantastic as opposed to my adolescent A1c's of 10 and higher!! When I was pregnant and testing about 10 times a day I had it at a 5.1.... I am POSITIVE I can lower this number and have tighter control with the aid of a CGMS. Having tighter control will keep me from or delay the complications of retinopathy, limb amputations, poor circulations, high blood pressure, stroke, etc.

I am SURE the insurance companies will begin to approve CGMS technology at some point, just as they approved pumps. I am also quite confident that CGMS will be integrated into all insulin pumps within the next several years. But the sooner I get my sugars in the tightest control possible, the longer I can live a healthy productive life with my family.

This is Me, Raising My Voice....

On December 25th, 2007 I almost died. On December 29th 2007, I almost died again. My blood sugar plummeted into the low 20's during my nighttime sleep. On Christmas I woke up screaming incomprehensible words and flailing my arms and legs, waking my husband. On December 29th, my husband's birthday, he mysteriously awoke and found me passed out on the floor next to our bed, minutes from death. (Happy Birthday sweet heart) There is a technology available that can prevent this from ever happening to me again.

It is a frustrating thing knowing there is a technology available to help free me from the daily worry of going into a coma, or passing out because of my hypoglycemia unawareness while I am home alone taking care of my children. Or dying in my sleep because my blood sugar gets to low. Yet this technology is being denied by major insurance companies in many cases, stating that it is not "medically necessary." It brings me to the point of tears sometimes. I have been waiting and waiting and waiting for my insurance company to come through for me and approve my Dexcom 7 CGMS, so I can be freed from this worry. Yet they continue to drag their heels. I haven't gotten a denial yet, but it has been pending since January. JANUARY! Ridiculous. I encourage diabetics to raise their voices and post this video by Manny Hernandez of Tudiabetes.com on your blogs!

Continuous Glucose Monitoring Systems are approved by the FDA and are some of the best diabetic technology available to help control blood glucose levels. The JDRF is working on completing this technology by researching ways to create a closed loop system as a sort of external pancreas. We are making strides.

I am tired of worrying about if I will be around to watch my children complete their major milestones. Graduating college, getting married, rocking my grandchildren for the first time, retiring and traveling with my husband. I want to live to see these years.

So I beg you, Raise your voice.




Find more videos like this on Tu Diabetes - A Community for People Touched by Diabetes



Also see: Six Until Me's battle with CGMS approval

Well, at least it's done....

I've been on the phone with Dexcom, Blue Cross, and my endo's office for 2 hours now. Apparently I have NOT been denied as first thought by the EOB I received from them stating nothing would be covered for the Dexcom. Someone dropped the ball and lost my "Letter of Medical Necessity" and the insurance company did not have it on file. Doctors office said Dexcom had it on file, Dexcom said they sent it, but Blue Cross didn't have it. So I just had my Endo's office fax a new copy of it directly to Blue Cross with ATTN: to the woman I spoke with personally on the phone. (Lynn) Hopefully she will receive it and get it into the hands where it belongs. I will try to call back on Thursday or Friday and make sure it was received though. I hate how long this process takes. It's frustrating. But at least there is still hope that it will be somewhat covered. I'd LOVE some more sensors so I could monitor my sugars more closely at night. It puts my mind at ease from those scary hypo's that I don't seem to awake to anymore till it's almost too late.

Denied. You suck BCBS!

I got my letter of denial today from Blue Cross Blue Shield Anthem (Ohio) for my Dexcom 7. I'll start my appeals process on Monday while the kids are napping. Don't worry, I will win this battle. I haven't used my Dexcom for a couple weeks now because I can't afford $240 for a box of 4 sensors. Grrrrrr......

Insurance Schmimshushrance

The nice Dexcom lady called me today to let me know my claim is on it's way. Best case scenario is 80% covered. I'll take it!! Now we pray. Lots. Please approve me. I only have one sensor left. I love this machine. I can't imagine life without it now. Especially at night... it's like a cuddly little security blankie that saves me from my hypo-unawareness while I'm sleeping.

I <3 My Dexcom 7.