Salty and Sweet » insurance

Latest scoop on the pump

Salty — Tue, 29 Apr 2008 13:33:43 +0000

I think it is time for an update on the case of the un-insurance-covered insulin pump and continuous glucose monitor system.

My doctor said we are finally ready to pursue my final appeal of insurance coverage for an insulin pump and continuous glucose monitor. It took a while to find and compile research studies since simply there are so few (we even had to wait for one to complete!). CF related diabetes is very rare, considering the size of the general population and it is also a fairly newly discovered complication of CF only since us cystics are living so much longer now days. I have figured there are only approximately 4,000 people in the US with CF related Diabetes. Finding info on it, none the less, hard data and research studies is very complicated.

Regardless of this, my insurance companay doesn’t care that I need to take up to 8-9 insulin shots a day, if I were to follow my prescribed nutritional needs. That is on a rough day. At a minimum I take 5 shots a day. Most diabetics with Type 1 diabetes take about 3-4 shots a day, minimum. My nutritional needs are much different than someone with Type 1, which makes things even harder to balance. My insurance company is not allowing coverage for an insulin pump because I do not have Type 1 diabetes…. now does this sound fair to you?!

I sent in my paperwork the other day, and my doc is sending in her stuff soon. Please wish good thoughts and send positive vibes for me and my future pump. Hopefully this time the reviewers will actually listen to my doctor and to common sense!

DENIED! – Explained.

Salty — Fri, 18 Jan 2008 04:54:55 +0000

I had to have my doctor translate the denial letters to me. I was denied the insulin pump because I do not have Type 1 diabetes. Which, they are right, I don’t. I have CF Related Diabetes. But I still NEED insulin. There are so few of us out there with CFRD I don’t think my insurance understands what CFRD is. Hopefully my doc can get their decision overturned after educating them about my challenges.

I was denied the Continuous Glucose Monitor because it is too new on the market (FDA approved it last year) and apparently there have not been enough studies to show that it is affective. I don’t see how this device would not be affective. I want it because I live alone and am deathly afraid of having a seriously low blood sugar level and passing out. So I err on the high side, which is not good for my body. With a monitor, I could set it to alert me if I started to go to low and I could treat it before I got to a dangerously low level. I wish they could understand that.

DENIED! – Insurance issues.

Salty — Wed, 16 Jan 2008 18:55:24 +0000

I am not sure why, I will find out later today, but insurance has denied my request for an insulin pump and Continuous Glucose Monitor. I am not surprised about the CGM, but floored they denied me an insulin pump.

Do they not realize I have diabetes? My A1c at last check was 9.0, three months before that it was 9.3. A normal A1c is between 4% – 6%. I am already experiencing complications with my kidneys due to this and it affects my CF too. Do they not see the benefit of giving me a piece of equipment that will help lower these levels and prevent further damage and further complications???

Why does insurance seem to lack the skill of logic?