CGM Anti-Denial Campaign Website

All you need to fight for CGM coverage.

Gina Capone
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  • NY
  • United States
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Gina Capone's Discussions

Sample Letters to send to Commissioner Daines
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Started this discussion. Last reply by kiyoumins dcsafsg Aug 4, 2016.

Terms and Conditions/Disclaimer
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Started this discussion. Last reply by nina Jeffers Apr 21, 2009.

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hxy1222 replied to Gina Capone's discussion 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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Jan 10
Stephen Contos left a comment for Gina Capone
"I have had the DexCom G4/5 for over a year and now HealthFirst Medicaid is refusing to cover. I had 1 Fair Hearing and won but now they are attempting to deny me since are and are refusing to provide coverage for supplies until the hearing...AGAIN!…"
Sep 8, 2016
kiyoumins dcsafsg replied to Gina Capone's discussion New York Assembly/Dept. of Health
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Aug 4, 2016
kiyoumins dcsafsg replied to Gina Capone's discussion Sample Letters to send to Commissioner Daines
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Aug 4, 2016
kiyoumins dcsafsg replied to Gina Capone's discussion Aetna Medical Directors
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Aug 4, 2016
kiyoumins dcsafsg replied to Gina Capone's discussion Empire BCBS Medical Directors
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Aug 4, 2016
kiyoumins dcsafsg replied to Gina Capone's discussion Insurance Coverage of Diabetes-Related Goods and Services in New York State
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Aug 4, 2016

Profile Information

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!

Recently, I got a call from Medtronic Minimed directly to say they were going to be handling my CGM Appeals.



(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…
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…

Continue

Posted on October 8, 2008 at 12:30am — 3 Comments

Comment Wall (61 comments)

At 2:29am on August 15, 2008, Mama Belle, aka Heidi said…
Thanks for the invite, Gina!
At 2:54am on August 15, 2008, Peter Barrett said…
Hey Gina. This is Peter. I just got an email from you. I have no idea how you got my name. I'm 55 and have hadType 1 for 40 years. I just started pumping two years ago, and now I'm ready for CGM. I have a great doc who's written a strong letter of support that I've not yet submitted. I'm expecting a fight from my insurer, Anthem / BC / BS of California. So, I'm delighted to see that you and others are working on this on the national level. You go girl. And I'll keep you posted as to what results I get from Anthem California.
At 3:12am on August 15, 2008, Mary C. said…
Hi Gina, Carefirst BC/BS of MD covered the Navigator CGMS for my 11yr daughter. I have the PPO plan and they covered 100%. We just started this past Monday and we LOVE it! It's like opening a window on diabetes so you can really see what's happening.
At 6:27am on August 15, 2008, Marshy said…
Horizon BCBS of NJ is listed as a company providing coverage; as of this posting this is no longer true.
At 8:50am on August 15, 2008, Linda Kallish said…
Hi Gina,
Why isn't Medicare on the list, or am I missing it? Thanks, Linda
At 8:59am on August 15, 2008, Stacey Nagel said…
Gina,
Add GHI ( Group Health Inc) of NY to the list..
they're approvong on a case by case basis..
Ours miraculously came thru in just under 2 weeks...
At 10:07am on August 15, 2008, Cynthia said…
I haven't even tried to get a CGM because I'm struggling to keep up financially with my pump. My insurance coverage - through CareFirst in DC - isn't great.
At 3:26pm on August 15, 2008, Tonya said…
Have you received coverage for the CGMS yet?
At 3:32pm on August 15, 2008, Tonya said…
I have Aetna PPO as well, and I think their policy is the same for here as it is in New York. Do you have a copy of the clinical policies? Aetna changed it in July to make CGMS medically necessary for type ones who have hypoglycemic episodes 4 or more times a day.
At 3:45pm on August 15, 2008, Tonya said…
Sorry, that was supposed to be "test 4x a day" I am at work, and some one was talking to me while I was typing. Should proof read!

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