CGM Anti-Denial Campaign Website

All you need to fight for CGM coverage.

I've been paying out-of-pocket for my Minimed CGMS since March (still appealing insurance, and will have to start over because my work is changing insurance companies - UGH!!!). It's saved my ass more times that I can count.

Yesterday was another perfect example of why these things should be covered by insurance:

Sitting on my bed feeling a little hungry, but otherwise perfectly fine. I hear the melodic BEEP, BEEp, Beep, beep that indicates I'm going low. The CGMS tells me I'm 70 mg/dl, and the graph indicates that I've been dropping pretty fast for a while. I feel great, so my first thought is that this sensor is dying a quick death, and it's probably time to replace it. The nagging part of my brain tells me to test just to be sure. A quick spurt of blood later, I face the reality that I'm 47 mg/dl. Still not believing it, I grab my other meter. Sure enough, I'm 45 mg/dl. I grabbed a juice box just as I start to feel some of the usual symptoms of a low (shaking, sweating, dizziness, fatigue, etc.)

So, I have two questions:

1. Why is it that I can't feel the symptoms of a low until it's upon me? Would I have ever known without the CGMS, or would I have just passed out?

2. Why can't my insurance company recognize that the cost of that one sensor is a hell of a lot less than the cost of an ambulance ride, hospital stay, and anything else that would have resulted from a severe hypo episode?

Denied by Aetna
Denied by UniCare (still appealing)
About to be Denied by CareFirst

Views: 45

Comment by Fred Goldberg on November 5, 2008 at 10:07pm
Shannon, it's common for diabetics to lose/lessen low-blood-sugar awarness. I've been a T-1 diabetic for more than 30 years, and when my Minimed CGMS starts to beep I'm going low (I HAVE MINE SET TO 76 FOR LOW) I know I have to do something! If it's not going down too quickly, I grab an 11g carb candy, but if it's moving fast, or already down to 70, I go for 10g of glucose.

I've only passed out twice, first time was moving computers around at work (more exercise than normal sitting at my desk) and then was 30 minutes late for lunch. I was talking on the phone to a co-worker in a different building, and slumped over on my desk. Guy I was talking to called someone near me, couldn't rouse me. On-site nurse gave me a glucagon injection, but that didn't help immediately either, so next was 911 ambulence trip to the E-R.

Sometimes I can feel low's coming, doctor told me can depend on how often that happens, and your body reserves of Adrenaline. For number 2, you have to tell them that in your appeal letter, along with doctor note saying why you need CGMS, and studies showing it is good!
Comment by Gina Capone on November 6, 2008 at 12:49am
1. That happens to me too sometimes.

2. they are cheap. keep fighting you can still win. I won!
Comment by kiyoumins dcsafsg on August 4, 2016 at 10:45pm

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