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SUM Questions Answered.

I've received a few questions about the Minimed CGM in the comments and I wanted to address them here, because when I started to answer in the comments section, I was waaaaaaay too wordy.  Here's the MiniLink FAQ, answered with my limited three day knowledge base.

Did your insurance cover your CGM?I love Legend of Zelda.

I had the good luck of finding a Minimed Representative who would let me trial the CGM for a few weeks in order to make a decision about making the MiniLink a permanent part of my diabetes management plan.  So this CGM is cost-free at the moment, or at least until I give it back and buy my own.  ;)

However, I have spoken to my insurance company, my various medical representatives, and other diabetics about getting insurance to cover a CGM.  The feedback varies, but the common theme seemed to be "need-based coverage."  At this point in my life, I have an A1C under 7% (believe me, this was a battle), I have not visited the emergency room as a result of diabetes issues, and I have not called the paramedics due to hypoglycemic unawareness.  From what I'm told, insurance companies look at me and think that I did fine without a CGM before, so there's no need for me to have one now.

Per usual, I don't agree with the sentiments of the insurance companies.  With my wedding in less than 5 months and motherhood on my radar, I want my diabetes to be as tightly controlled as possible.  Wearing a CGM to ward off excessive highs and to protect me from debilitating lows sounds to me like a terrific way to prepare my body for babies.  That's not reason enough to be approved for coverage?  I don't like being told that the only way I'll get a CGM approved is if I'm visting the emergency room.  Shouldn't the point of having access to this technology be aimed at preventing those moments, not reacting to them?

More on insurance coverage in the coming weeks, as I decide what role a CGM will play going forward.  But believe me, I will not go quietly into that insurance mess. 

What I want to know is how you got the sensor in your arm.

Ah, tricky one, this.  Thanks to my friendly neighborhood Minimed rep and my inability to be completely shy, my rep helped me place that sensor on my arm.  Otherwise, I'm not sure how I would have held the sensor in place while withdrawing the needle.  Even now, as I change the bandaids that hold the transmitter in place, I need to enlist Chris's help.  I don't think I could have placed it effectively without help. 

Does it feel weird to have it in your arm, though?

Not really.  Since I don't like employing my abdomen as a holding place for diabetes devices, I was happy to use my arm for this first sensor.  I have to be careful when I take my clothes on and off (like last night, when I almost ripped the transmitter from my arm with my bra strap), but I encountered that with my thigh sites when I first started using those for pump sites.  My brain just needs to adjust.

I did have a little trouble at the gym two nights ago, during my run.  Thanks to the bandaid becoming a bit unsticky and the fact that I was wearing a sleeveless shirt, the transmitter became a little loose and started shaking about.  I had to cut my cardio short to keep the sensor from flying out, but my next plan is to wrap a light ACE bandage around my bicep to hold the MiniLink in place.

I wanted the CGM to be unobtrusive and discreet for this debut.  The arm placement helped me achieve that comfort level.  Now I feel less daunted by the technology and more apt to try different placement sites. 

I'm happy to share my experiences with this device, and to answer questions as honestly as I can.  Thanks for your questions, and let me know if there is anything you're curious about, or what your experiences have been like.  I'm so new to this device that I appreciate all the feedback on it, good or bad, that I can find.

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RE: the insurance.

I wonder when insurance company's will figure out that those who care to be in better control will achieve EVEN more better control with new techie toys whereas those who don't won't, regardless of the technology. From what I've heard (and experienced) not anytime soon. :)

Minimed's best move: integrate CGM sensors into the infusion set, make it an integral part of the pump, jack the price of the pump 20% and make it a non-option. (Understand I know zilch about CGM technology - only that so long as insurance companies have the "option" to pay, in most cases, they won't.) :)

Ah, if only they could figure out a way to integrate the infusion set and the sensor. Unfortunate thing is that the sensor can't be too close to where the insulin is being piped in, or that would skew results. As it stands now, my sensor needs to be at least two full inches from my infusion set. I removed as much variability as possible by chosing a whole separate limb. ;)

I started after Keri and was ready to give up yesterday, but today was a much better day and I have been 130-134 all afternoon, which if you subtract 20% means 100-102, so I skipped my 2 hour test after lunch, it was hard but I did it (and lunch was not diabetic friendly) and when I got home I was still hanging around 134 and I tested on my meter, 102, ding, ding, ding.

I caught my self going high this a.m. for whatever reason, as I did not eat breakfast and I bolused and got myself back to 124, but then I started to go low and caught that as well. Yeah CGM!!!

Yeah me!!!!

I have been fighting with my ins. company since June and won my appeal right before Christmas!! I have many documents and a great letter if anyone needs help, I can send to you.

I use the Nexcare invisable medical tape to hold my sensor in place it works great .

Hi Kerri,
I'm really enjoying reading about your CGM experience.

Another comment regarding the combo sensor-set. Because many people are getting sensors to last for a week or two, combining them would require a sensor change every 3 days as well.

I was denied the first time and MiniMed is trying to help me get an approval, but like you Kerri, they think that because I haven't been in an emergancy room since '04, and my a1c is 6.7 that I am fine. I don't agree. I think that I need a lower a1c and I want the CGMS to help me with that!
And like Marcus, I agree that technology won't make someone take better care of themselves. They have to want to do it anyway. There are plenty of people out there that are are on an insulin pump and still think they can do whatever they want and be fine.
CGMS should be for those of us who are trying to do better and need some help!
Fight for it Kerri! Let's hope your insurance company comes through for you.

I use a cheap version of horse tape to hold the dexcom sensors on my arm. It is called shoot. Can't find the stuff now. It is self sticking tape. You can get it in flesh colored also for a bit more money.

Sensors are officially impossible to place in your arm by yourself. I tried. I did okay until there was NO WAY I could get the needle out till I sheepishly asked my room mate, "Will you pull this needle out of my arm?" And she said, "Gah, ew, ok."

Good luck with the CGM Kerri. I am going to be starting on the pump in a few weeks. I bit the bullet and ordered the CGM with my minimed 522. I'm going to be fighting them tooth and nail to get it covered because $330.00 for 10 sensors is a little (no a lot) steep for me if I want to use it on a regular basis.

Good luck to both of us.

Thank you for answering all of the questions. When I got my CGM in April I did so without consulting my insurance company because I had just found out that I was pregnant. Surprise! After appealling their first refusal I was very close to getting them to pay for it because of the pregnancy. I do not know if they would have approved it because I miscarried. I would love to get info from Karen on her approval. If you could put us in contact I would really appreciate it.
Thank you

Hi Kerri!

I just wanted to stop by and say that even though most insurances are not yet paying for this WONDERFUL technology, I've personally found it so very helpful - I just had my first baby on Dec 10 and while we did have some complications, I know that it would have been a lot worse had it not been for the sensors. I also would love to get the information from Karen too... ten months of sensors and two transmitters out of pocket later and I STILL want to use them! Thanks!!


If you provide me with your email addy I can send you some documents.

Thanks for answering questions and sharing all this stuff!

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