Which insurance covered your CGM

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Permalink Reply by MelissaBL on August 11, 2008 at 3:03pm

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.

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Permalink Reply by Lee Ann on August 11, 2008 at 3:08pm

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.

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Permalink Reply by Marcy on August 11, 2008 at 3:08pm

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

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Permalink Reply by Mollie on August 16, 2008 at 12:33pm

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.

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Permalink Reply by Liz on August 11, 2008 at 7:03pm

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.

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Permalink Reply by Denise on August 11, 2008 at 9:10pm

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

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Permalink Reply by cdw on August 12, 2008 at 8:57am

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

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Permalink Reply by Mike Campana on August 12, 2008 at 9:08am

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.

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Permalink Reply by Amber Evans on August 27, 2009 at 11:10pm

Minimed transmitters have a productive life of about a year (can be less, only guarantee 6 months) - Minimed was horrible about disclosing this at time of purchase when i started 2 years ago and my first only lasted 8-9 months - I got new then and have gotten 3rd since started. My budget includes a new transmitter each year.


Healthnet I am told is last hold out in California not covering but they covered one period (3 months) after many requests then refused next with no explanation

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Permalink Reply by Mike on August 12, 2008 at 12:10pm

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.

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Permalink Reply by Felice on March 4, 2009 at 5:07pm

Hi ,
We have cigna as well and wanted to get the medtronic pump with the cgm. {our warranty is up } what kind do you have and how much of a process was it?
felice

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Permalink Reply by Jim Devlin on March 5, 2009 at 8:40am

Hi Mike, I'm about to send in my package of 1st appeal paperwork. Medicare BC/BS Advantage Plus.-Mich.. Attempting to get Navigator. I feel I have gathered all information including medical studies printed from comp.
I don't know what, not in this packege, I could include in a very possible second appeal. Was told by CGM person, Abbott, that never has Abbott (Navigator) been approved in Michigan by BC/BS.. She also told me that my paperwork contents are very good. good. With my ever worsening Hypo. unawareness, I certainly need this.
Do you know of any 1-2 things that were what turned the tide for you.
Any help would be appreciated.
Jmi Devlin

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