I want one

I am working on getting the pump, but I am also interested in the CGMS, what are the requirements to get one? how does it work?

Hi Nicole.

Requirements for getting CGMS depend on what insurance you have (if any).  If you don't have insurance, then it's just a matter of prescription from your MD.  If you do have insurance, contact your insurance company.  They may want BG logs for a certain amount of time as proof you require the CGMS, and a detailed letter from you MD.  The letter should point out why CGMS is needed---like examples of high A1c's, frequent ER visits/hospitalizations for low BG treatment, extreme proof on hypo-unawareness, examples of why BGs may fluctuate often (exercise, non-normal working hours/conditions, etc)---any medical reason that may prove it more cost effective to be using CGMS than not use it.  I've seen suggestions of quoting costs of the CGMS systems vs ER visit and/or ambulance costs to get to ER., costs of CGMS usage vs long term diabetes costs down the road.....stuff like that.

Have you chosen which pump you will get?  The Minimed has an integrated system ....and supposedly the the Omnipod and Animas will at some point be integrated with those pumps (they aren't currently, so that means carrying to devices around, pump and CGMS monitor *whereas MM only has to carry one device around.

If It were me, I'd try to get a trial of each of the CGMS systems and see which works best for you.  Some work better than others for different people!!

Hope that helps!  If not, try doing a web search for CGMS denial tips.  There are a lot of great sources of info around that your MD could model your letter on!

Michelle  MM722 and CGMS

Nicole,

Michelle has already given you some great starting points on what you'll need.  Here is some more information from the JDRF website, detailing a step-by-step process for obtaining coverage for a CGM.  It goes into some great detail that should be helpful to you.

http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=60525BBF-1279-CFD5-A739A8849799ECF9

Best of luck!

Kim