Comment by Suzanne on June 9, 2009 at 7:03pm

Mike,

You gotta go to an endo ASAP. They write and RX to the pump company once you decide which one you want. I suggest asking the endo what kind of relationship they have with the pump reps to see if you can get a loaner to try multiple pumps. The doc will also have to fill out paperwork for the insurance company proving medical necessity for the pump. This will be no problem for you since you were just in the hospital due to DKA.

What makes you a good candidate? Being T1 or T1.5 is a big reason. Alot of insurance companies fight giving pumps to T2s for some reason. A desire to bring down your a1c is another reason you would be a good candidate. Doing MDI (more than 2 shots a day) helps you case. Having problems with crazy blood sugar trends helps. I actually got turned down the first time I asked for a pump because I only did 2 shots a day and I hadn't been hospitalized due to BG issues!

Why would they deny you? They don't want to pay the upfront cost. They may have a policy that they always deny people the first go around to see how serious you really are about a pump. They may want to be sure you are seeing an endo for a certain amount of time, like 12 months, before they OK it. They want to make sure if they buy you this expensive piece of equipment that you will actually use it and see the endo like you are supposed to. They may want a 3 to 6 month records of your BGs to see if you really are out of control so if you don't have this, they say no. It all just depends on how your insurance policy is written.

I am sending you positive thoughts and wishes that your insurance company is one of the cool ones that says OK just because the endo said it was medically necessary :)

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