CGM Anti-Denial Campaign Website

All you need to fight for CGM coverage.

Insurance Companies that HAVE covered CGM

If your insurance company HAS covered you, and you don't see it on this list please send contact Gina

• Aetna of New York
• Anthem BC/BS of Tennessee
• Anthem BC/BS of Virginia
(case-by-case basis)
• Horizon BCBS of NJ
• Blue Cross Blue Shield of Minnesota
• Blue Cross Blue Shield of Nebraska
• Blue Cross Blue Shield of North Carolina
• Blue Cross Blue Shield of Illinois
• Independence Blue Cross
• Carefirst BC/BS of Maryland (PPO)
• Empire Blue Cross Blue Shield, NYC
(case-by-case)
• GHI ( Group Health Inc) of New York (case-by-case)
• Medica
• Medical Mutual of Ohio
• Tricare Prime
• Tricare (Military insurance managed by Humana) Texas
• United HealthCare
(case-by-case basis)
• Aetna
(case-by-case basis)
• HealthPartners of Minnesota
• First Administrators
• International Medical Group (per Budapest)
• Regence BCBS of Oregon
• Mamsi/United Health Care Optimum Choice
• Premera from Blue Cross, Seattle

Visit CGMS Central for more information on CGM.

CGM Billing Codes

The billing codes for CGM for the above companies are:

A9276 for the sensor
A9277 for the transmitter
A9278 for the receiver

Visit CGMS Central for more information on CGM.

Forum

Stacey

Independence BC PA 7 Replies

Started by Stacey in Welcome. Last reply by Leslie May 24.

Beth

Why hasn't anyone signed up yet?

Started by Beth in Connecticut May 19.

Phil Lerner

Blue Cross and CGM's 9 Replies

Started by Phil Lerner in Rhode Island. Last reply by Phil Lerner May 6.

Gina Capone

Insurance Coverage of Diabetes-Related Goods and Services in New York State 4 Replies

Started by Gina Capone in New York. Last reply by nina Jeffers Apr 21.

Cynthia

Diabetes and Exercise 2 Replies

Started by Cynthia in Welcome. Last reply by Cynthia Apr 21.

Gina Capone

Terms and Conditions/Disclaimer 2 Replies

Started by Gina Capone in Terms/Disclaimer. Last reply by nina Jeffers Apr 21.

Laurie

BCBS IL Medical Directors 6 Replies

Started by Laurie in Illinois. Last reply by Dan Sprehe Jan 22.

Denise Force

The update... 1 Reply

Started by Denise Force in New Jersey. Last reply by Gina Capone Jan 21.

Denise Force

The battle begins 2 Replies

Started by Denise Force in New Jersey. Last reply by Denise Force Jan 21.

 

Huge Clinical Trial News

JDRF Funded Clinical Trial Demonstrates Continuous Glucose Monitoring Improves Blood Sugar Control
Study Findings Presented at the European Association for the Study of Diabetes meeting and Reported in the New England Journal of Medicine Indicate CGM Can Help Type 1 Diabetes Patients Lower HbA1c Levels, Better Control Diabetes

Here is the link to the study:
CGM and Intensive Tx of DM1.pdf

Sign the CGM Anti-Denial Petition





DiabetesTalkfest.com launched the CGM Anti-Denial Campaign Petition on July 14, that will be sent to all major Health Insurance Providers. The goal is to get at least 2000 signatures by November 14, 2008—World Diabetes Day.

Current number of signatures as of 10/08/08: 2,324
Number left till goal: 0
Our goal has been reached!

Announcements


Are you, or is someone in your family, using a continuous glucose monitor (CGM)? Are you considering using a CGM? If so, you probably know that most health plans currently provide either limited or no coverage for these devices. In the coming months, JDRF will step up its efforts to expand health plan coverage for the CGM. You can join this campaign by responding to this short survey. The first step is to let the JDRF know your healthcare provider.
---------------------------------------------------------------------------------
• By joining this site you agree to the Terms/Conditions

• If you have any useful information that you would like to see on this site please contact Gina Capone

• If you have been covered, tell me what kind of plan you have through your insurance. For example is it Carefirst BC/BS of Maryland (PPO) or (HMO). What kind of individual plan you have makes a difference. Contact Gina

•Tell us what steps you took to gain coverage through your insurance plan, and post them in your STATE CATEGORY along with the insurance company that covered you.

CGM Companies


dexcomFreestyle navigatorMinimed

CGM Anti-Denial Campaign information box

I have created a forum for every state in the U.S. find your state category and please provide the following (you can use NEW YORK AS A GUIDE):

1. Identify the person(s) by State and Country who have the power to make it mandatory for insurance companies to cover CGMs.

2. Identify the lobbyists by State and Country who will go to bat for us to bring this forward.

3. Find a website link to the "law" that is currently in place regarding diabetes supplies coverage in your State or Country.

4. Find out by State and Country what has to be done in order to make this happen.

Jdrf tips for obtaining CGM coverage


STEPS FOR OBTAINING CASE BY CASE COVERAGE FOR CONTINUOUS GLUCOSE MONITORS (CGMs)
Many health plans are waiting for the results of more studies like JDRF's clinical trial on continuous glucose sensors before making broad coverage decisions. However, in the meantime, some health plans are granting individual or case by case coverage. We encourage people who are using or plan to use continuous glucose monitor (CGM) technologies to apply for case by case coverage. Here are a few tips we have obtained from insurance experts that can increase your odds of success. More from the JDRF>>

CGM Studies to download

 
 

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Blog Posts

Marion J. Edge

TRICARE and Navigator sensors

Posted by Marion J. Edge on May 21, 2009 at 8:00pm

RON BARD

ANTHEM BCBS WI

Posted by RON BARD on December 17, 2008 at 5:12pm

Christie Jensen

Please email me about CGMS denials

Posted by Christie Jensen on November 23, 2008 at 11:55pm — 3 Comments

Michelle2008

My Type 1 Diabetes needs help!!!

Posted by Michelle2008 on November 5, 2008 at 1:03am — 2 Comments

Shannon

CGMS Saved the Day (again)

Posted by Shannon on October 30, 2008 at 1:45pm — 2 Comments

Latest Activity

Christie Jensen left a comment for davidJune 17
david left a comment for Christie JensenJune 17
Marion J. Edge added a blog postMay 21
TRICARE considers CGM to be nice but not needed. Therefore, TRICARE will only approve three months worth of Navigator sensors at a time. Then, one must fight for additional coverage all over again.
 

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