While I've heard of the imperfections with the CGMS's, I still would LOVE to have one! My pump isn't perfect either, but I wouldn't dream of giving it up.
In December I'm eligible for a new pump. I'd also like to get a CGMS. BUT, from what I've been told, my insurance company will be looking for numerous readings in the 50s prior to approving coverage for a CGMS. I have a number of problems with this...
#1: The insurance companies will not approve a device that's proven to be a helpful tool for diabetics, unless they have enough complications. What constitutes "enough"? How much danger do I need to be in to warrant a useful tool?
#2: This encourages diabetics to put themselves at risk of having, a widely-known danger, lows. Let me tell you, as soon as the pump representative "unofficially" told me what the insurance company would be looking for, I adjusted my pump settings. Twice last weej I was stuck on a train with no food or juice (it's not allowed-though I frequently bring some anyway) with my sugars in the 40s.
#3: The insurance companies don't even cover a great deal of the pump or CGMS supplies. Even when I had "100% Rx coverage" it only covered about 30% of my pump supply order! I realize these products are expensive - but they're life-changing!
#4: If insurance companies are allowed to do this to diabetics - 1 - how much further will they be allowed to push us? 2 - what do they do to people with other medical issues?
#5: By not approving a proven aid in the management of an incredibly complicated disease, the insurance companies are PUNISHING those who have decent control of their sugars! If they were approving all diabetics with imperfect sugars, they'd be approving every single diabetic.
#6: The CGMS alerts for high sugars too! Why in the world aren't people with high A1c levels & multiple high readings allowed access?!?! It can help them too!
#7: Most insurance companies had even more restrictive regulations on CGMS approval just a year ago and only eased up when thousands of diabetics started and signed petitions. Why is it they will only change their policies when they're threatened with the idea of their injustice being publicized? It's infuriating!
I did absolutely nothing to get diabetes - I do not deserve to be punished for having it, nor do you!
Here's to hoping Christmas will not only bring a shiny new pump - but a CGMS too!
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"Enough" complications? HA HA. One complication was enough for me. Never again will I have a friend of mine who is a nurse look at an infection in my leg and say, "If you want to keep your leg you need to be in the hospital now."
ReplyDeleteI supppose if the bean counters go through what we do sometimes, they would have a better understanding. Loss of a limb, blindness, death...They are some pretty heavey complications. I use injections. I don't use a pump but a family member does. This whole insurance fiasco I play close attention too. I haven't encountered any problem YET but....