Does Kaiser Permanente cover CGMS?

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Permalink Reply by Casey Washington on November 5, 2009 at 6:06pm

there are requirements that are hard to meet (depending on which Kaiser plan you have). I am trying to figure out a way to get it too. If you hear anything, please let me know!

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Permalink Reply by Stephen Woodward on November 16, 2009 at 11:34pm

I was successful in getting my CGM through Kaiser.

Be persistent, log the day, highs and lows to show unawareness issues. Sell them on it based on Kaiser's participation in the CGM study released in Oct. 08. The study demonstrated that the people who benefit the most from CGMs are those that test often, wear the CGM as much as possible, have a CGM of 7.1 or less and "sell yourself" and the challenges that would not be there if you had the pump.

Talk to your local CDE at Kaiser to get a product rep to give you one for a few days. Keep pushing on the frontline professionals who you see to get them on your side. Test alot and give them the details

I had an A1c of 6 and alot of unawareness of my lows. I have to admit, the best thing about the pump is the reduction of stress I have experienced since going CGM.

I live in Livermore and it was a struggle. The criteria to qualify includes visits to the ER, the Dr and other Hypo emergencies. Note that the people who participated in the stud with 7+ A1c and inconsistent users of BGs and the CGM.

Good Luck, it as worth the fight.

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Permalink Reply by Terry O'Rourke on November 17, 2009 at 12:13am

John,

The Juvenile Diabetes Research Foundation (JDRF) has made a significant commitment to the Artificial Pancreas Project (APP). There are links on this page to recent studies conducted by the JDRF. These studies provide strong and persuasive support for any insurance application or appeal for continuous glucose monitor system (CGMS) coverage.

One of the main sub-goals of that project is to promote private insurance coverage for CGMS. At this JDRF APP web page, they list insurance companies that currently cover CGMS. Check it out. It shows that Kaiser for Northern and Southern California cover CGMS for Type 1 insulin dependent diabetics.

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