All you need to fight for CGM coverage.
Gina Capone's Discussions
Case Study: Successful Use of a Single Subcutaneous Continuous Glucose Monitor Sensor for 28 Days in a Patient with Type 1 Diabetes
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Started this discussion. Last reply by Doris Ann Dickerson Aug. 28, 2008.
Sample Letters to send to Commissioner Daines
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- Which insurance company denied you?
- Aetna (PPO) New York
- What kind of CGM do you have/want?
- Minimed Real-Time or Guardian
- How did you hear about the CGM Anti-Denial Petition?
- diabetestalkfest.com
Gina Capone's Blog
Keep your fingers crossed!
(GINA NOTE: I was denied 3 times and on the third denial I was also laid off from my job so I couldn't pursue further.
I went onto my husbands plan right after I got laid off. The next day I called up my CDE to tell her my insurance would be changing and that it was still the same insurance that I had… Continue
Posted on October 11, 2008 at 7:46am — 1 Comment
A call from Medtronic Minimed
Yesterday, I was at work doing my daily duties and at about 2pm my cell phone rang.
Me: A little reluctant to answer because it looks like a spam caller I do anyway..Hello?
Caller: Ms. Capone
Me: Yes, that is me.
Caller: This is "M" from Minimed calling in regards to your appeal for a Continuous Glucose Monitor.
Me: A little excited...
… ContinuePosted on October 8, 2008 at 12:30am — 2 Comments
Comment Wall (53 comments)
- At 11:54am on September 22, 2009,
Jennifer Anderson said… - It's Health Net of California. It's not listed on your site.
- At 9:06pm on September 21, 2009,
Eva Clarke said… - Gina,
My insurance company is BC/BS of California. We have the PPO policy.
Good luck.
- At 6:26pm on September 21, 2009,
Jennifer Anderson said…
- Gina,
Have you heard anything about Health Net of California? I am going to get the ball rolling with my daughter's endo next week to get her a CGM. Diabetes Camp told us to get appealing and eventually we'll get it as long as we produce the nubmers. Any input or information?
Thanks!
- At 10:01pm on July 23, 2009,
Toni Crebbin said… - Gina, I am happy to say that I got a letter from my insurance today, Regence BlueShield, and they have authorized me for the Dexcom Seven Plus! This was a total surprise to me, as they denied me about 1.5 years ago for the Dex Seven, so I have been paying out of pocket all this time. Dexcom filed all the paperwork, along with my doctor, and I didn't have to really do anything. I'm not sure yet at what %, but something is better than nothing! Keep up the good work Gina:)
- At 1:47pm on May 20, 2009,
Jessica Slate von Goeler said…
- Hi Gina,
This site rocks! It is so dumb the battle in getting CGMS coverage. It took me almost a year and an appeal with political pressure and I got Tufts Health Plan in MA to cover it. Of course, on a regular basis, my claims are denied and I don't find out until there is an adverse action (like my entire account at Minimed is put on hold). Every time I mount a full blown campaign and get it resolved. It is so worth the fight.
Jessica
- At 10:16pm on May 5, 2009,
Phil Lerner said…
- I have been fighting BCBS of RI for more than 2 years with no luck at all despite numerous appeals. Two weeks ago Minimed called me and said BCBS of RI was now approving CGMs. They sent my doc a preprinted form, he signed it and today my CGM arrived. I can't believe it. All good things come to those who wait. Gina, I wish you all the best in what must be very difficult times.
- At 1:28am on February 27, 2009,
Craig McCulloch said…
- I have Blue Shield of California - HMO health plan for California State Employees. My health plan paid 100% of the pump, CGMS and sensors to date. No appeal process was needed. My endocrinologist documented my hypoglycemic episodes needing assistance, especially at night. I've had the CMGS almost three months adn am looking forward to my first A1c with it.
- At 1:59pm on January 25, 2009,
Kevin Wells-Knecht said…
- I have Cigna insurance and they've done a good job covering my Dexcom and supplies.
- At 1:07pm on January 24, 2009,
Kevin said…
- My insurance is covering my CGMS. I have never had a problem. My insurance company is Empire Blue Cross Blue Shield. I have had some hypoglycemic episodes which have proved to be life threatening. The CGMS helps out tremendously.
- At 9:21am on January 20, 2009,
Don Muchow said… - Hi Gina! Thanks for all the great work you are doing! My insurance is HealthNet. I kind of figure these guys will be the (second-to) last ones on the boat (I saw somewhere they were rated second worst in a survey), but I am still keeping my fingers crossed.
About
Blog Posts
Help needed
Posted by thomas radcliffe on October 17, 2009 at 9:04pm
Recently got HealthNet to reverse their denials and cover Dexcom CGM for our six year old son
Posted by Ron Anderson on September 22, 2009 at 11:04am
Tricare Prime denied CGM because child under 7...
Posted by Kelly Houck on August 11, 2009 at 7:21am
TRICARE and Navigator sensors
Posted by Marion J. Edge on May 21, 2009 at 8:00pm
ANTHEM BCBS WI
Posted by RON BARD on December 17, 2008 at 5:12pm
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