Frustrations with Insurance and Diabetes Supplies: My Own Vent Session

I have been a pumper for over 14 years now. I have worn both the Medtronic and Dexcom CGM (Continuous Glucose Monitor) for many years. I think both the insulin pump and the CGM make it easier to control my diabetes, thereby improving the risk of long term complications and expenses to the health care system. The same can be said for testing blood glucose levels multiple times a day. It would seem that this up-front cost seems to help prevent larger costs due to poorly controlled BG levels in the long run. This of course is only my opinion. Why then is it so difficult to get coverage for these lifesaving and cost reducing items?
Let’s start with simple blood glucose testing strips. I use a fairly popular meter, a very generic drugstore brand lancer and the lancets that accompany this device. There have been major studies that say MDIs (multiple daily injections) lead to better health. This would also mean that multiple daily testing would be required. Why then, do insurance companies limit the number of times a day that a patient can test? Are they concerned that there are a few diabetics out there that are overly cautious? There are indeed a few. Are they concerned that with more testing, more patients will over compensate and over medicate? There are probably a few.
Why then, if an endocrinologists writes a prescription for testing 8-10 times a day, do they limit that number? I realize that there must be a cutoff of some sort. Could we say something more like 50? Even better, I could accept a limit of 24. That would be one test approximately every hour at most. Most endos would not need to write this large amount, I feel certain. Instead, I waste time and money by continually getting a partial fill on my prescriptions and having to return to the pharmacy more often. If I really want to go into the carbon footprint of such, I could throw in things like, extra gas, pollution from driving, extra hours for pharmacy employees, extra bags wasted, extra paper wasted for receipts, etc. OK, I am sure the insurance companies could provide even more in depth numbers for their side. I realize that I have not thought this through to a research or statistical significance level to any extent. So that is my complaint on testing strips.
Now, moving on to CGMs. I spent nearly 7-8 years using the Medtronic CGM. I loved this at first. I gave my husband many more “bonus points” than he probably deserved for letting me own one of these expensive contraptions. It helped curb my highs and lows and helped me achieve excellent HA1C levels while working a very hectic schedule. After 28 years of needles, I am not one to shy away from them, much less complain about them. This CGM however, hurt like crazy! It was big. I bled more than usual for a majority of the time. It flopped around and the adhesive tape was just plain unattractive in my opinion. Not that anyone wearing numerous devices inserted into their bodies are going for “fashionable”. I still was a fan for a long time. Then as time went by, I felt mine was less and less accurate. I began to start adjusting BG readings to make sure that my CGM was keeping up with my real BG numbers. What was the point in that? Diabetics make up numbers from time to time, but this was not to make my levels better. This was simply to help make my GCM keep up with my real readings, regardless of the levels.
Despite these issues, I was never declined by insurance. I was never asked questions if it was a necessary item, as long as I had a prescription. I didn’t have to prove that I needed it. How would one “prove” that they needed it anyway?
I then moved on to try the Dexcom CGM. This was much smaller, with a thinner cannula, and the adhesive was better for me. I was astounded by the better accuracy that I could have with this version. I struggled to acquire this gadget. In a business that seems to reap huge profits, they didn’t seem to want my money. I was not having enough low BG readings. I was struggling with having high BG readings at the time. Why then would I be declined? I was still trying to improve my health. Most of the medical costs and problems come with years of high bg readings, left untreated. Wouldn’t curbing these highs, be a huge benefit to health just as much as preventing low BG levels? This was very frustrating.
I eventually acquired my Decom and I loved it. True, it was another handheld device that I needed to keep up with. I needed to keep it charged and change my sensors regularly. The accuracy was worth it! This went along perfectly until one morning I went to charge my receiver and the usb port actually got pushed into the device. I could no longer charge it and therefore could not use it. When I called customer service The very nice man understood exactly what happened. It must have happened before. He would kindly replace it if it was still under warranty or I could get a new one if it was out of warranty. Mine was out of warranty. It had lasted longer than they expected. That sounds kind of like a good thing to me, if I made a product. However, to get a new receiver, I have to go through the re-enrollment process again! I am currently receiving case upon case of the sensors, yet can’t get a replacement receiver to save my life it seems!
My doctor has cleared this, my insurance company covered it recently, but they won’t help me get a new one. I would even just self-pay for a new one, if I could get anyone to give me a straight answer! Ok, maybe I wouldn’t due to cost, but it still doesn’t help me get any answers. Why are they making it so difficult for me to take the best care of my health?
So there is my little rant on devices. If I had to truly debate this issue, I would honestly need to do some more research. This is simply an example of my frustrations “off the cuff” so to speak. I know that there is a serious need to regulate the pharmaceutical industry. Those that abuse prescription drugs have thrown us a wrench. However, I think that those living with a chronic illness deserve a little break. So, to be continued as the story unfolds! Good luck to those of you with the courage and resilience to continue to fight the good fight to maintain your best health! Keep striving for the best care, even when it gets tough!

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