Which insurance covered your CGM
Can you please list here which insurance company covered your CGM and under what terms?
Replies to This Discussion
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Permalink Reply by Mike Campana on -
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 -
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 -
You should plan on replacing transmitter roughly annually. They are only warrantied for 6 months and tend to fail in the 10-14 month range. Fortunately my plan covers the transmitter as DME with a $1,500 cap, but all supplies, including sensors under drug benefit.
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Permalink Reply by Hope on -
mine more for more than 3 years. My endo has had the same one since 2004, so some of us are definitely getting more than one year out.
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Permalink Reply by Mike on -
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 -
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 -
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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Permalink Reply by Dave on -
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.
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Permalink Reply by Emily Whiting on
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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%
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Permalink Reply by Crystal on -
I used to have tricare through the military and when I went to get my pump I had to contact my govenor to get them to finally approve it. It was crazy.
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Permalink Reply by J. Davis Harte on -
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.
:DH
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Permalink Reply by J. Davis Harte on
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I think I'm covered at 100% - that's what Minimed told me, but Regence hasn't sent me a bill yet, so I'm keeping my fingers crossed!
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