Continuous Glucose Monitors and Insurance
I was scanning through my previous posts and realized I hadn’t mentioned some very big news from 2009: my insurance plan now covers continuous glucose monitors and supplies!
I think I forgot to mention this because I’ve been using a CGM since 2006, but not very much back then because of the cost. I used it as much as I could afford though because I could see the value of the device in my HbA1C test results. In 2006 and 2007, I had to pay for 100% of the supplies because my insurance company didn’t cover them. At that time, they barely knew what a CGM was, I think. In 2008, they covered a ridiculously small portion of the cost. How ridiculous? If I had bought sensors as often as they would allow (every month), by the end of the year, I would be about 10 dollars short of satisfying the annual deductible which I recall was 250 dollars. Part of that was because the CGM manufacturer was considered “out-of-network” and therefore was covered at a lower amount.
In 2009 I saw an end to that though. I remember placing an order for supplies in early January of 2009 and having two things be different. First, they were allowing me to place an order for a two-month supply rather than the one-month supply they allowed in the past. That alone meant I would be paying half as much in shipping. The second thing that was different was amount they were charging to my credit card. In the past, it had been about 250 dollars and now they only needed a 10% co-pay (about 30 dollars). Very nice!
As happy as the end of this story has been for me, people all across the country continue to struggle with their insurance companies to get coverage for what is, I think, the best thing to happen in diabetes care in the twenty-first century. This is despite numerous studies (for example, here and here) showing their effectiveness in helping to manage blood sugar levels.
If you’re still fighting for coverage, check this site out:
CGM Anti-Denial Campaign Website – All you need to fight for CGM coverage.
