[scratch101]

Hrmn, seems I'm in this boat with y'all as well. Got approval a few months back for my CGMS (minimed, hooked up to my Paradigm 522) and everything was looking good, had my first 30 pack (3x 10) sets of sensors, and when I was finally getting near to ordering another supply from the 'distributor' I get a call from them telling me the supplies are no longer covered by my health insurance Empire BC/BS (for NY State employees). So I have a call in to them to see why they would approve the system/transmitter, but now not the sensors or the occlusive dressings.

Let the fun begin.

[purplestinker]

congratulations, sorry if I'm lost, which insurance cover it?

[KEVIN88GT]

Originally Posted by scratch101

Hrmn, seems I'm in this boat with y'all as well. Got approval a few months back for my CGMS (minimed, hooked up to my Paradigm 522) and everything was looking good, had my first 30 pack (3x 10) sets of sensors, and when I was finally getting near to ordering another supply from the 'distributor' I get a call from them telling me the supplies are no longer covered by my health insurance Empire BC/BS (for NY State employees). So I have a call in to them to see why they would approve the system/transmitter, but now not the sensors or the occlusive dressings.

Let the fun begin.

Cuz they want YOU to pay for it.... FIGHT THE POWER! (My insurance HIP in new york also covers it for like a 10 day try... as if thats going to help me, I will try it for 10 days see how it works for me... if the readings are accurate I'm taking them to court)

[KEVIN88GT]

guys I'm probably going to end up going to court through the state (New York) for a hearing regarding HIP Insurance denial the CBGM. I need to be prepared to do battle. What literature out there is there that shows the efficaccy of CBGM. I need things to show during the hearing when my insurance states "It's not a medical necessity"

[JediSkipdogg]

Originally Posted by KEVIN88GT

guys I'm probably going to end up going to court through the state (New York) for a hearing regarding HIP Insurance denial the CBGM. I need to be prepared to do battle. What literature out there is there that shows the efficaccy of CBGM. I need things to show during the hearing when my insurance states "It's not a medical necessity"

There isn't much research yet which is why the insurance companies have such a great foot to stand on. Currently there is only the Star 1 and Star 2 trials conducted by Minimed. Finding the results of those two study trials should be in some medical journals out there. That's about the only research to date and it's not really 100% effective research because it has people on MDI compared to people with pumps and CGMS combined. Which pumping alone can offer a significant improvement.

The Star 2 trials (estimated completion in 2010) will compare MDI users to pump users to CGMS users to pump & CGMS users. It's the only study being conducted on a widescale basis to show the true effectiveness of CGMS and pumping. I feel once that study is out (unfortunately gotta wait the time) then insurance will gladly pick up CGMS without question.

Sorry I can't be more help, but right now there is little research showing how great CGMS is. It's all a personal word of mouth and it varies at how much it can save insurance (if any.)