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I know that most insurance doesn't cover CGM. But I've heard of various people who have appealed their insurance rejection and gotten coverage (at least for the sensors, if not the transmitter/monitor). I'm trying to create a list of all the insurance companies that have covered CGM. If your's has or you know of one that has, please post the name and address (if available) of that insurance company.

CGM is a great tool to supplement our BG control and the more we put pressure on insurance companies, the more likely it will start being covered.

Tags: cgm, insurance

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Congratulations!!!!

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I have an option to switch insurance to Group Health Cooperative, Seattle. Has anyone had success with CGM coverage with them?

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Health Alliance Plan (HAP). I think this is Michigan only, not sure. I will pay the first 20% for the entire CGM product. Getting it Jan. 1st.
Left Blue Cross and joined HAP, in order to obtain the CGM, which goes into effect Jan.1. I am also on Medicare as I'm over 65. HAP is my secondary Ins.
HAP requires me to be a Type 1, have an Endo., and supply 30 days of most recent blood tests. They need to be sure I need a CGM. I will have no problem with any of these requirements.

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Do you know if Medicare pays toward the CGMS as your primary? My husband just recently was enrolled in Medicare as he is on disability for end-stage kidney disease from his diabetes. I fought for 1 year with Keystone Health Plan East to get coverage for the CGMS. And then when Keystone is forced to cover it, they pay hardly anything! I owe MinMed hundreds & hundreds of $$$$. My account is constantly "on hold" & my husband had to stop using the CGMS as a result. I just completed all those ridiculous and time consuming requirements for Medicare to cover his diabetes supplies but never inquired about coverage for the CGMS, I was so wrapped up in all the mind-numbing bull I had to deal with.
Thanks!

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Hi Cindy, unfortunately no, Medicare will not cover CGMS and they do not make exceptions. What you'll need is a secondary insurance, not a medicare supplement, that will cover for CGMS and that a provider is willing to work with. You may want to look into some of the Blue Cross and Blue Shield PPO policies.

Best of luck, and I'm sorry this is so difficult! If you have any other questions I'm happy to try to help!

Daniel

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