My neighbor Carol just called me. She is a type 2 on Lantus and Novolog injections, and her doctor just put her on Victoza and told her she may have low blood sugars. She had previously been on Januvia and metformin, but her doctor took her off them and put her on insulin. He also told her that Victoza cures type 2 diabetes because it causes weight loss. She told him about my Dexcom and he gave her a script for a Dexcom. He told her she could get one locally. I gave her the phone number for Dexcom and told her to call them and they could take it from there. She has the same insurance company as me, Excellus BCBS, and I told her they would probably want blood sugar logs showing lows below 50. She doesn't have a log, and hasn't had low blood sugars, but because she lives alone she wants some protection in case she starts having lows. Any thoughts?
I thought I would have to send my new Dexcom back after BCBS wouldn't pay for it too, but thankfully my appeal won. Now knowing what stinkers the insurance is, I'll be very careful before ordering anything new. You call the insurance and think you're ok to order something, and then someone down the line says no you can't have it.
I'm hoping that Carol will be able to work something out with the hospital so she can afford to pay. I wonder if she would be able to appeal their decision?
Sue, I forgot you actually had yours in hand when they did that! They do that stuff with tests too. I needed to get an MRI and the doctors office had to call for a pre-authorization. They were given the authorization number but also told that was not a guarantee they would pay for it. My cousin's husband had that same thing when he had surgery. How can you send back tests or surgery? Why bother with pre-authorizations if they aren't going to guarantee payment.
I would try to appeal the exercise. The worst that could happen is they say no. I think they get away with saying no to stuff because most people don't bother to appeal things.
Kelly, I was also told that there was no guarantee they would pay for it. I got it in February, and when I finally got the explanation of benefits, it said they hadn't received the information they had requested. In April I got the denial letter. I figured by then Dexcom would refuse to take it back.
I've had my OmniPod for four years now, I imagine it's probably out of warranty. I hope when I have to order a new one, BCBS is better about covering it.