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September 5th, 2008
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 CGMS Denial Day

 

 

I want to be healthy. I want to live as long as I can. I want to be complication free. I want to not have diabetes.

 

3 of those 4 statements above I can actually do something about. I can watch what I eat, exercise, and check my blood sugar all the time. I cannot cure myself but if I can take care of the other three then I would be doing pretty good in my book.

 

Here is the problem. Checking my blood sugar 8-10 times a day only gives me snapshots of what my blood sugar is doing at the moment. If my blood sugar is 130 now, what is 80 an hour ago or 300? Having that kind of knowledge would eliminate many hypoglycemic episodes and hyper ones too.

 

We can all agree that keeping my BG in control is the best thing I can do for my d-life. The more in control I am, the better my chances to stay complication free. That should be the goal for all people with diabetes. My question is, what do our insurance companies think our goal should be? To not spend a lot of money? Should our goal be to lose our eyesight and let them replace our kidneys if need be?

 

Continuous Glucose monitoring systems are a reality now. Sure it is not entirely accurate but it does show trends and that information is something we have NEVER had. Knowing where I was and where I am going is important and allows me to be proactive and not reactive.

 

But that makes me wonder what insurance companies expect from us. Would they rather react when we have a major complication or be proactive in doing all they can to avoid it?

 

I, along with many others, have been denied by insurance to cover CGMS. I will continue to fight for my right to know what is going on in my body. Hopefully if all of our voices are heard we can get the insurance companies to understand and to cover it for us.

 

Have you tried to get CGMS covered by your insurance? Did it work?



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Seems to me we have two "insurance" worlds for patients. People who have insurance advocating for Cadillac care and people without insurance who need to have access to basic care. Forcing insurance companies to cover expensive technology when so many people struggle to afford care at all isn't right.


If having my insurance cover CGMS means that someone does not get care then I would never EVER want it. But that is not the case.


I'm fighting right now in fact.

I'm considering just giving in and paying for it out of pocket and continuing to fight for repayment on the side. I'm afraid that might ruin it for others in my area though...


I think the insurance companies don't want to pay for it right now because they are gambling that when someone needs a kidney, etc, they will be on somebody else's plan. Or it won't impact this quarter's profits and allow them to make their bonuses. I'm beginning to think that the problem is the stock-market driven corporations. They only care about this quarter, to the detriment of their customers and their long-term business plans.


I am very fortunate to have an insurance company that covers most of my CGMS and my pump supplies as well. After just a few months with it I can't imagine going back to not having it. But I do believe that more and more insurance companies are coming around to paying for them. I am hopeful that up front cost of the CGMS will far outweigh the future costs of complications. Good luck to everyone with their pursuit of better control, and better insurance coverage :)


I had no problem getting my CGMS. Most difficult thing for me was a couple of phone calls to my CDE and Endo to get a letter of necessity and lab results trends. Best thing we found after about 6 mos of use is my A1c finally dropped below 8 to 7.8. Keep trying and working the insurance company, cause I don't think kidney disease, dialysis, blindness etc is cheaper than a CGMS set up.


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George Simmons
George Simmons is a father and husband living with type 1 diabetes. A self proclaimed "born again diabetic," George began blogging as a way to meet other people living with diabetes and learn more about managing his disease. (Read More)

Latest Posts: Raging Against the Machine | It Will Probably Win | The Stress of Stress

Nicole Purcell
Nicole has lived successfully with type 1 diabetes for 25 years. She hopes that by writing about her experiences, she can help others to face diabetes - and its challenges - head on.(Read More)

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