I am at a loss as to what to do in this situation. Last week I had contacted my insurance company to find out what type of dressing was covered to use over my sensor and during the same conversation I was told "oh by the way your CGM isn't covered"!! I have to explain this to you, I received my CGM the end of September 2011, yes that is 4 months ago now! So needless to say I was back and forth between Medtronic and my insurance company pretty much all Friday trying to get this straightened out. According to my insurance company they now "have to pull the phone conversation" that took place to see what was actually told to the representative at Medtronic.
Has anyone ever had this happen to them? Would my insurance company be able to deny my coverage now even though I've had it for 4 months now?
If your policy changed at the beginning of the year, yes. That always worries me.
My husband changed jobs last summer, old job insurance United Healthcare. New job, UHC. Thought all would be fine. No. I always have companies I order supplies from verify when insurance changes, company I use said all covered through UHC (sensor, Dex, pump and supplies). Ordered pump supplies, no problem. Ordered replacement sensors - oops - big problem, not covered item. Really? Everyone is being told it's covered. Lots of phone calls, getting benefit person of husbands company involved, etc. Got it paid, BUT --- with this company husband works for, UHC covers my pump supplies but Pharmacy covers my Dexcom. So I order pump supplies and bill UHC, order Dexcom sensors and bill Medco. (Where to get the Dexcom sensors now that's another long story!).
If you have prescription coverage check to see if they will provide.
Hi Korrie...Nope insurance coverage hasn't changed at all. Unfortunately my prescription plan won't cover any of my diabetic supplies. I have to use my DME coverage to get all of them which is through my regular insurance carrier. It will be interesting to see what they have to say. Thanks for the input.
my dexcom sensors are also covered by my Pharmacy, and I order them through Foundation Care, who bills my Pharmacy. Don't know what your 'long story' is, but FC has been very easy to work with.
If you are lucky Eileen, the phone conversations will show your insurance company saying yes to all being covered. That is what happened to me with the changes, and it was not until the claim was submitted after I had received a 90 day supply of sensors that the denial came in. Since UHC continued to tell every company that called to verify, and because I went corporate and got my husband's benefit person involved, UHC accepted responsibility and paid my claim. Maybe you will be lucky too!