Hey everyone! I was diagnosed about 7 months ago and am eager to be on pump therapy. I meet all of the requirements except for a c-peptide lab test result. It is a little above what my insurance requires. I haven’t heard of anyone else with this problem. My Dr believes I am still in honeymoon, but I can tell the honeymoon could be over (since my levels have been running a little higher) but I’m not 100% sure. So my question is why is this c-peptide result holding me back? It is really frustrating. I need some explaining about initially starting the pump (insurance coverage, honeymoon, etc). I just don’t see why I can’t get the pump just because i’m still slightly in the honeymoon phase. Thanks!
the politics of insurance is mind boggling. they want to know if you are making your own insulin so the c-peptide test tells you if you are making your own insulin and if you are, how much insulin. If you are making enough or your own insulin, you don’t (according to your insurance company) deserve pump therapy so they wont pay for it. It is more of a type 2 diabetes issue than a type 1 issue. There are ways around it but you have to be okay with aggressively threatening your insurance company. good luck.
ADuke, I hear you. Who is asking for the c-peptide test, your insurance company?
A year ago when my second pump was more than a year beyond the basic warrantee and I wanted to get a new one, Medicare insisted that a c-peptide was required - that was after 57 years on insulin therapy. My doctor insisted that one wasn’t necessary but to satisfy the government [a $368 cost] it was done and showed my c-peptide was less than 0.01% [that is part per thousand of less than 0.0001] - which the endocrinologist interpreted as “… that just couldn’t find any”.
Go ahead, jump through the hoops and start with the pump - just wish I had started many years ago. Live life to the fullest and I hope to still be here to welcome you into the 50+ Medalist Group.
Yes I am on medicare as well and they require the c-peptide test for full pump coverage. I am doing everything I can to get on the pump but this silly test is preventing it :(. I know I am making some of my own insulin, but an insulin pump would make life easier. Thank you for the response.
I started pumping in 2007. My C-peptide was required, and it showed less than .01%, like Dennis’ report. I did not know whether I was supposed to fast for the blood test and so I ate breakfast, and did not take my insulin. If I do not eat breakfast I can go very low. I went to the lab immediately after eating. Of course my fasting number in the report was unusually high. I do not know if that helped me get the pump approval, but I did get approved, without a problem. Pumping is great!!! My best control ever!
Aduke, We all know it is frustrating but believe me, the honeymoon won’t last. If you can tough it out a few more months, I guarantee your C-peptide will plummet and you will meet the requirements. Yes, Medicare makes you jump through hoops. Unfortunately, that NEVER changes. I believe I speak for all of these people when I say it is a daily battle for scripts and supplies. Good luck! The pump is worth every minute of it!!!
I’m glad to hear the pump is worth the wait! I’m going to the endo in a week so hopefully she will have good news! Last time I had labs done I did not fast, so I definitely will try that this time around.