An Open Letter to Insurance Companies
Today, after nearly three months of waiting, I received news from my insurance company that I have not been approved for a CGM, specifically the Enlite sensor from Medtronic that pairs with my pump. The external medical reviewer said they did not find a justifiable reason, based on my past two months of blood sugar values, for me to need a CGM.
Here is why this is not acceptable:
Type 1 Diabetes is an auto-immune disease that preys on the very young, the youth, the middle-age, and the old. It cannot be prevented. It has no cure. It does not go away. It has no definite cause. In addition, it is also deadly.
My body no longer produces the hormone insulin. I must inject insulin into my body 24/7/365; and the injections need to be precise. Too much or too little can kill me. I administer insulin alone, without medical supervision. I cannot regulate my blood sugar naturally, like non-diabetics can. I cannot know, based on feeling alone, where my blood sugar is. I also need to measure my blood sugar with a blood sugar meter at least 8+ times a day. That means, for 8 seconds of each day, I know precisely my blood sugar value.
For eight out of 86,400 seconds in one day, I am aware of where my blood sugar is. That’s .0009% of each day.
That is dangerous.
It’s especially dangerous because I am no longer able to feel low blood sugars. This means, that because I do not have approval for a CGM, I must leave my blood sugars higher than I would typically let them be, so that I do not end up with a severe hypoglycemic episode. That is why the external review came back with no need for a CGM.
It should also be known that higher than normal blood sugar values are also, over a longer period of time, deadly. High blood sugars can lead to many complications that impact the heart, eyes, kidneys, and limbs (just to name a few).
I did not ask for type 1 diabetes. I also normally do not complain about having the disease. But today I have had enough. I do not have access to a simple device that can save my life. A device that has been in existence for over a decade.
I do not have access to a device that can save my life because the price of the device is not accessible, even to pay out of pocket. The device and its accessories cost 4,523 EURO per year. Minus 950 EURO for year two because one piece is durable medical and is continually re-used. This is not affordable for me, or for the majority of others.
All I ask, is that I am supported in obtaining a device that can save my life, before I lose mine.
note: I am living in Germany and have German medical insurance. But this is an all too true reality for many diabetics, no matter which country they are from.
UPDATE: I was able to appeal the rejection letter and was finally approved! Thank you, Germany.
Just read this post. Insta buddy. I joined as a follower. (I live within Twin Cities too). I have been turned down for a Dexcom, bc i am not T1 and lows woth trial device were not under 50. T2 insulin deficient . I am still waiting to hear on an appeal that health care team is working on. I am afraid the answer will be no again. Sharing frustration of thos process. 😐
I’m so sorry to hear this. I hope you gain coverage soon. Are you injecting insulin?
Hi Leah I feel for you have been struggling for over 6 months to get the cgm on my insurance too but no success as yet why oh why do we need to struggle????
Hey Janine, I will also never understand why we need to fight and beg for medication and technologies that significantly change our lives. I hope you receive good news soon!
I feel your pain! Have you considered the Freestyle Libre? I’m using it. I prefer it to the Dexcom G4. It is not real-time, but provides very useful information. Here in Australia it costs approx AUD2400 per year, which is about 1600 Euros. Much cheaper than the Dex.
Hopefully this is sorted!! I was the Sam in Brisbane Australia 2+yrs ago, I applied but was declined because my T1D wasn’t life threatening apparently, my endocrinologist then wrote a letter and contacted my insurance then accepted my claim on the second time 🙂