Hey guys, I'm about to apply for insurance (cigna) pre-authorization for the dexcom. Don't really have any idea what to expect. It seems like a lot of people have gotten the run-around from various insurance companies. Just wondering if any of you had dealt much with them on the CGM issue and had any idea what to expect, what might make them approve or deny, etc.
No word yet, although apparently they called my house today, I'm out of town on business so they haven't gotten through to my cell yet. Pretty speedy actually since I actually just submitted my insurance info, etc to dexcom over the weekend. Did they tell you how low your hypos needed to be? Brad mentioned 55 or below was his requirement. What a silly world we live in-- Why do they insist on seeing hypos? The idea is to be in good control all the time--- not to chug whiskey and take too much insulin, and jump rope in a sauna until I pass out just to prove I need a medical device...
I started my first sensor today:). I did pay quite a bit for the Dexcom as I have a huge deductible, but I feel the cost was outweighed by what the CGM can do for me. Have you checked into just buying one, so your not a slave to the Insurance requirements?
How do you manage the ongoing cost of the sensors? I'd be willing to buy the CGM monitor myself if I needed to-- but the ongoing cost of the sensors would ruin me...
Thankfully, my insurance did approve the sensors, there is a cost to me of $50 bucks every two months(8 sensors). I must say I contacted Dexcom directly at the urging of a fellow at Animas, I received Laura Gonzales as my rep. Laura did it all, contacted the Doc, Insurance, Durable Medical Equipment provider, I mean everything. I simply had to say "send it" and I had it in two and a half business days. Laura placed the order on Friday midday, and I had the unit and sensors on Tuesday at about 1pm.
Let Dexcom work for you, they want to sell their equipment, so they will do all the leg work and make it quite easy for you.
Apparently with CIGNA they go through some third party group called Care-centrix or something like that. I really don't understand what role they serve, other than some sort of middle-man between the patient and the insurance-- hopefully it doesn't complicate matters. I'd be happy to buy the device if they'd pay for the sensors. What did the unit cost?
Yep, same thing with United Health Care, they go through Diabetes Specialty Center. It just has to do with the underwriting of various plans and contracts the insurance companies have with the "middle men." It doesn't affect the bottom line cost (for me at least).
Dexcom is enroute! I usually deal with the government all the time at my work, so it was so refreshing to see that outside of that world, things still actually work and happen like they are supposed to. No hassles, no excess paperwork, no logs. Sailed right through. Their rep said that Cigna insurance is the best and never gives anyone a hard time! Should be here tomorrow!
Good deal, let us know how everything goes.
I have Cigna and Dexcom, and have also had Aetna. Previously I have also used Freestyle Navigator.
As a general rule, if you have a history of losing your symptoms of lows, you are generally a pretty good candidate for a CGM. I lost mine a while ago, and have been hospitalized twice for seizures due to low blood sugars. That of course is doing it the hard way.
Cigna is good with Dexcom - although I had the unit when switching to Cigna and just use them for the sensors. With Cigna, they will subcontract to CareCentrix who will bill you for the final amount after insurance, but the Dexcom staff were great and everything has gone very well with Cigna.
Good luck with CGM, there is no doubt it will change your life for the better.