Wednesday, January 23, 2008

Denied

Just for fun I called Minimed and checked into getting CGM to go along with my pump and as the title suggests I was denied.

I had a feeling this would happen. Just because I have Blue Shield which sounds like a company that protects it actually does not give a $#!^ about its patients, only money. Silly me. So now what to do? I guess I can sell stuff on eBay to afford CGM? I know my endo won’t do anything to help. He hardly knows me. Maybe I should see if Doctor “F-Bomb” with kick some insurance ass.

Odds are I will not have CGM for a long time. Oh well.

I am having a crappy day. Don’t mind me.

10 comments:

Andy Rhodes said...

Hey man, I have Aetna. My doctor is at a specialty place called Diabetes. Anytime I say I have Aetna, I hear sighs from the doc/educators/anyone else. HOWEVER, I was just approved by Aetna for the CGMS. I had to do an appeal. The doc and educator wrote a letter of necessity and maybe something else. They also sent the numbers from a 3day trial of the CGMS I did with them. < 1 month for the process. Now waiting for them to be shipped. The woman at the insurance told me that there's a Texas Diabetes Mandate that says any new technology approved by the FDA and assumed medically necessary by the doc, has to be approved. Plus, I'm type 2 as well.

Chris said...

Sorry to hear about the Denial. I was denied as well but I am going to post an appeal. There is a really good thread on Tudiabetes that talks about the process of appealing the CGM denial. You may think about looking at that.

Good luck

George said...

Thanks for the tip Chris. I always forget to check out TuDiabetes for advice. I do not hang out there enough.

Jillian said...

Aww George that stinks! Some insurance companies are so dumb. I'm glad I have absolutely no interest in CGMS, otherwise I know my mom would probably be throwing down the gauntlet in a fight with our insurance.

Caro said...

Sorry to hear this George, it sucks.

Obviously I don't know much about the insurance process since our system is completely different (and after 18 months of trying, I still haven't gotten covered under that either!) But from what I've read it seems there may be a bit of a trend for companies to turn down the first application as a matter of course. I think they figure that if you're serious about it, you'll appeal. Still sucks.

Hope something works out for you (and that your day has gotten better!)

Shannon said...

I concur with everyone who said try again. But the next time, arm yourself with a doctor's note saying that it is necessary because your A1C's are high or whatever reason your doctor can manage to come up with.

Like Caro said, insurance companies usually deny the first time and come around if you're persistant and keep appealing.

From experience, when we're turned down for something Brendon needs concerning his diabetes, we talk to a higher-up the next time we appeal it. Never talk to a basic customer rep.

caramaena said...

Ah that sux George. Go the appeal!

Sara said...

Everyone else has said appeal - so I say give them a swift ninja kick you know where!

Windy said...

I'm in the appeal process right now with BCBS Anthem. Maybe I should tell them I know a ninja. =) Like your blog! I'll add you to my list.

Hannah said...

Dear Insurance Companies,

Stop pwning those of us with d1483t3s, plz. Its not so 1337.

love,
yr fr3inds on teh intarwubs

Heehee, hope you enjoy the laugh. Honestly, I'm not too upset that I can't get CGM yet. I still feel like it's more trouble than it's worth, especially for a long period of time. But that's just me...some coverage would be nice, though.