Continous blood glucose monitoring

[sharishine]

Has anyone obtained the new continuous blood glucose monitoring system from minimed? My father who is a Type I (as am I), has purchased it. Unfortunately, the insurance company will not reimburse him for it because it is still "so new". I'm just wondering if anyone else has purchased one of these and if so, what experiences have you had with insurance companies?

Thanks!

[Jackets]

The Guardian® REAL-Time Continuous Glucose Monitoring System (http://www.minimed.com/products/guardian)

This is the first I've heard of it. Very interesting.

[catgalla]

I'm dying to get that monitoring system for myself. My diabetes nurse educator informed me the other day that insurance should be covering that really soon. I think it's a wonderful idea.

[rocky]

I am getting one with my pump within the next few weeks. I believe my company covers the same for it as they do the pump. I'll let you know more once I actually get it. I am definitely excited about it, to know what my BG is at all times of the day.

[sharishine]

I will be surprised if they cver it the same way they do your pump. My insurance company, and my fathers, both cover our pump and supplies, but WILL NOT cover this new insulin pump - and supplies (which is where it gets expensive). Please keep me updated on what your ins company decides. Thanks!!

[cat_collector]

Hi , Im waiting to hear if my ins is going to cover this , when I called them they said they would cover it so my endo is sending in the order well see what happens .

Tracy

[atlfokus]

I'm working on getting this in a month or so...

I have to wait for my warranty to expire on the one I have currently, then I have to get approved I guess.

I dont think my insurance is going to cover it at first, but I was told as time goes on and it gets more popular, they most likely will. But for now, it going to be like $350/month for supplies.

I've talked to a few people who claim its just amazing, and a friend of mine got to test it for three days and she agreed 100%... I can't wait.



..pCe..

[Keezheekoni]

Insurance companies who cover a pump will cover this one, just without the CGMS. It's just their regular pump with the added ability to work with their CGMS...

I hear that most insurance companies will begin covering the CGMS part of it sometime next year, however knowing insurance companies like I do, most will probably deny coverage until you appeal their decision a few times.

There are a few people on the board here who have gotten their insurer's to cover it. Hopefully they'll post soon.

[It Ain't Over]

Had a discussion with the Mini Med CDE last night. She said the problem is there still is no HCFA # for the Minilink, and none for the CGMS.
Without that the insurers refuse to recognize this as a medical device. So it takes additional effort to get them to accept the rx your doctor sends in. Said those with success have gone up beyond the first and sometimes beyond the second levels of no sayers to get approval. Takes both yours and your MD's effort to get it done.

[orsaugen]

DexCom reports that Medicare/Medicaid is favorably disposed towards approving coverage for its CGMS. There was a public meeting on May 1 (no reports out yet) and the excpectations are that at least the DexCom device will receive a HCPCS code by January 1, 2008, when Medicare and Medigap will cover the devices and, we hope, the consumables.

[Harold]

Moved thread to Monitoring.

How much does it costs without insurance? As a type2 not on insulin it may not be necessary to wear it everyday, say 3 days a week. Getting a real picture of what's happening over the course of the day will show up problem areas not seen with finger sticks. Know I have them comparing A1c with monitor averages shows I am missing something.

[sharishine]

It Ain't Over: What exactly is the HFCA# and the CGMS?

The insurance companies will pay for the actual pump, because its just a pump. Its the sensors that they will not cover yet.

[spirosway]

In others countries your insurance pays for continus glycose monitor?In Greece all these stuff are very very expencive!!!you need 1000E or 1300$ for monitor and other stuff 1000$ every month!!!its crazy!!!

[bizonia]

I am on this system(PRT by Minimed) for already 2 months ,but I am disappointed with it.I don't know when to trust it and when not.Some days its reading(BG)are correct,some are not.Sorry if it sounds not so nice,but I am sure they will approve it, so there is a hope! I really do not mean to be critical at all , I just share my experience with you.

[rmccully2000]

These are billing codes the insurance companies use.


It is NOT true that insurance companies won't cover CGM until the CMS creates specific codes for it!!! Don't buy it if your insurance company or an endo or CDE gives you this line. It is misinformation.

We obtained insurance coverage of Dexcom on the first try using miscellaneous durable medical equipment code. MM and Dexcom reimbursement specialist have these codes if you need them.

We now pay 10% for all CGM supplies (about $17.50 per month) since we also won in-network approval recently.

Best of luck!
Becky,
Mom to Mason, 7 Dexcom


It Ain't Over: What exactly is the HFCA# and the CGMS?

The insurance companies will pay for the actual pump, because its just a pump. Its the sensors that they will not cover yet.

[pooh3465]

I am on medicare as my primary insurance and the way they have explained it to me is that i can get it but i will have to pay 79.00 of the expense I never thought about if they would cover the supplies for it though I guess I better get to checking on that...I hope all goes well with your insurance ccompany I will say a prayer for you

I am on this system(PRT by Minimed) for already 2 months ,but I am disappointed with it.I don't know when to trust it and when not.Some days its reading(BG)are correct,some are not.Sorry if it sounds not so nice,but I am sure they will approve it, so there is a hope! I really do not mean to be critical at all , I just share my experience with you.
Your not the first person i have heard that has gotten it and wasn't thrilled with it my endo has a nurse there that has one but she said it was a pain to have on while she slept and she thought it was easier to just stick herself....but I still want to try it I am trying really hard to keep my sugars under control for once in my life so I think it would help

[PinCushion]

WOW! I am impressed. May I ask what insurance carrier you have? I am with Blue Cross of California....according to the lady at Minimed (I am in the process of trying to get a pump...my insurance wont pay for the pump, but will pay for supplies) told me that my insurance won't pay for the transmitter OR The sensors that have to be changed every three days. I think that having CGMS would help me more than the pump itself at this point.

[someone]

I have been using it for a little over a month now. It has been great despite a few issues and sensors that I had to discard. I am not getting insurance reimbursement as of yet. I have posted a lot about it in the forum here. Try doing a few searches on the subject.

she said it was a pain to have on while she slept and she thought it was easier to just stick herself....

Then your nurse does not fully understand the benefits of continuous glucose monitoring. I have no problem sticking myself 20 times a day, but the trends that I get from my continuous monitor are priceless.

[bizonia]

WOW! I am impressed. May I ask what insurance carrier you have? I am with Blue Cross of California....according to the lady at Minimed (I am in the process of trying to get a pump...my insurance wont pay for the pump, but will pay for supplies) told me that my insurance won't pay for the transmitter OR The sensors that have to be changed every three days. I think that having CGMS would help me more than the pump itself at this point.

In my country the insurance doesn't cover anything. I am lucky to have a father who can afford the supplies for my pump and the sensors as a 3-months period trial. I already know I cannot without my pump but I really hesitate about the continuous device. I am sure if it was reliable enough I would give anything to keep it too.

[BlueSky]

.... the trends that I get from my continuous monitor are priceless.
Do you wear this thing all the time, or just to identify trends? I would have thought that having a pump canula AND a CGMS sensor inserted under your skin at the same time would be a bit much ...

[someone]

Do you wear this thing all the time, or just to identify trends? I would have thought that having a pump canula AND a CGMS sensor inserted under your skin at the same time would be a bit much ...

Yes, I wear it all the time along with my pump infusion set.

[bizonia]

Yes, I wear it all the time along with my pump infusion set.

I wear it too all the time since 2 months but except the trends(ups and downs) I don't see any other advantage because it shows me false results very often and I have to calibrate it at least 4 times a day.Only one 4-day period it was accurate.Do you encounter the same problem? Usually what are the differences between your meter and the CGM by Minimed?

[someone]

I wear it too all the time since 2 months but except the trends(ups and downs) I don't see any other advantage because it shows me false results very often and I have to calibrate it at least 4 times a day.Only one 4-day period it was accurate.Do you encounter the same problem? Usually what are the differences between your meter and the CGM by Minimed?

It has proved itself to be accurate for me.. as long as I insert the sensor at the proper angle, it usually gives me very accurate readings. As long as you calibrate when your BG is stable, and you have a good sensor, you should be fine.. The difference between the monitor and my meter vary depending on how well I have calibrated it.

Honestly, inserting the sensor at the correct angle is the hardest part for me. Some have found that 90 degrees works, but I have only been able to get the sensor to work reliably with a 45 degree angle (which for me means positioning the inserter at about a 55 degree angle).

Also, what meter are you using? You need an accurate meter or your calibrations are just going to be everywhere. I have tried BD, Freestyle flash, and One Touch Ultrasmart. Out of the 3, I have had most luck with the Ultrasmart, BD being second choice and Freestyle being the absolute worst.

[someone]

I forgot to mention, calibrating when you are below 70 or above 170 is also bad. The continuous monitor is most accurate in this range, and accuracy will begin to degrade as your blood glucose rises.

[bizonia]

I forgot to mention, calibrating when you are below 70 or above 170 is also bad. The continuous monitor is most accurate in this range, and accuracy will begin to degrade as your blood glucose rises.

I think I started to get the possible reasons for the great differences. First, I try to insert the sensor in the same way every new one, and I try to follow the isnstructions by Minimed.Second, I use Onetouch Ultra and it has proved to be accurate to me. Last but not less even in this range(3-18 mmol/l) the monitor has shown wrong results.But I already used to it and I know I have to check my BG more often than not to be sure what corrections to make if I have to.I think my mistake, if it is appropriate to talk of mistakes here, is that I expected too much-no more fingersicks and perfect exactness for such a high price!
Anyway,10x for the advices! I hope they will be helpful! I hope sooner or later the "artificial pancreas" will be fact!

[someone]

I think my mistake, if it is appropriate to talk of mistakes here, is that I expected too much-no more fingersicks and perfect exactness for such a high price!

I expected the opposite. I expected to be testing even more often, and I expected it to be at least 20 mg/dl off from my actual BG. Contrary to my expectations, it is usually off no further than 10 mg/dl provided my BG is not changing faster than 4 mg/dl every 5 minutes, in which case I would assume that I am lower/higher than it says.

Sorry it hasn't worked for you, but it has worked great for me. As with most things, I guess some have better experiences than others. It has been reliable enough that I am able to skip 1-2 tests a day, not that it matters to me since testing does not bother me.

[nab486]

Hi all,

I've been away on vacation but I wanted to jump in on this conversation. I received my Real time monitor (I am paying for it out of pocket because insurance said no way) the day before we left for a trip. I was very excited to have it while traveling because that is when I usuaully have the most trouble keeping my BG where it should be. It was AMAZING. There is definitely a learning curve, but being able to whip it out and check it while in line for a roller coaster and give myself a little boost of insulin was awesome. I found that after the first day I was within 15 points of my meter almost all the time ( I messed up the first day and calibrated too often when I was unstable.... :confused: learning curve). I also was able to peek at it during the night, give an adjustment, and go back to sleep without ever getting out of bed or waking my husband. Again very cool.

It is expensive. I am wearing the sensors 7 days to stretch it so it is going to cost me about $140 per month, but I figure I could spend more than that on a lot of other much less worthwhile things. My A1c usually runs pretty good (6.1 or so) anyway so I will have to wait and see if it comes down with this system. I am guessing that it will because I can catch my numbers riding up and stop them early rather than realizing 2-3 hours later that I am high and didn't even know it. I do find myself peeking at it constantly... it is a new toy I guess, but I love being able to know what my BS is ALL the time.

its cool:)

[xMenace]

I just found out that my endo, who I don't hesitate to criticize, has been sending letters to insurance companies for all his pump patients asking them to approve these things. I'll get him to add me when I see him next month.