Approved!!!
I have been approved!!!!!!!
They're covering my sensors. I cannot believe it. And from what I've been told, I'm one of the first on Connecticut's Oxford Health Plans to be approved for CGM use.
Also from what I've been told, it takes an external appeal to make it happen. So if you are fighting for CGM coverage, DO NOT GIVE UP. Keep fighting! Appeal every denial. Make sure you don't miss any appeal deadlines! It seems like insurance companies deny everything at first and only approve once you battle back. So keep fighting, and do not give up! (And use exclamation points! Ahhh! I'm so excited!!)
The tools to live well with diabetes should not just be for the people who can afford them. Fight for your right for coverage.
Comments
YAY! Congrats! Persistence pays off!!!
Posted by: enrico | October 3, 2008 02:54 PM
Oh my gosh! How incredibly awesome! Nice work!
Posted by: Colleen | October 3, 2008 02:58 PM
Wow! That is so awesome!! I hoped the external appeal would do the trick for you! I hope you love it as much as I love mine :)
Posted by: Lee Ann Thill | October 3, 2008 03:01 PM
Wow ... congratulations! Too bad my healthcare plan was switched from Oxford to Empire in July!
Posted by: Scott | October 3, 2008 03:02 PM
WOOOHOOOO!!!!
Posted by: Manny Hernandez | October 3, 2008 03:07 PM
Congratulations!!!
Posted by: Liz | October 3, 2008 03:08 PM
YAY!
that calls for some celebrating!
:)
Posted by: sari | October 3, 2008 03:09 PM
OMG OMG OMG
Congratulations! This will be so great for you!
Posted by: Amalas | October 3, 2008 03:14 PM
Excellent news Kerri! Congratulations. I hope that they'll become standard for insurance coverage. I don't mind having to jump through some approval hoops - I sometimes think we want all the latest toys whether we need them or not - but the approval process needs to be clear and reasonable so that those who need the technology can get it.
Posted by: Zazzy | October 3, 2008 03:15 PM
Cool! I'm so happy for you! Do you think your tag line on your check had anything to do with it?? :D Oh, well, it was well worth it, since it worked. Congrats.
Posted by: Cara | October 3, 2008 03:41 PM
Great news! :)
Posted by: Berci Mesko | October 3, 2008 03:45 PM
Yay! Congrats, Kerri!
Posted by: Jason | October 3, 2008 04:01 PM
OH MY GOODNESSS!!!!!!!!!!!!!!!! This is such exciting news, congratulations!!!!!
Posted by: Seonaid | October 3, 2008 04:21 PM
Hot Diggity!
WOOT WOOT!!
That is awesome.
Posted by: molly | October 3, 2008 04:29 PM
SO EFFING AWESOME!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Posted by: George | October 3, 2008 04:31 PM
Congrats, but does this mean they won't cover the cost of the Dex itself? Were you looking for that, too?
Posted by: Lyrehca | October 3, 2008 04:37 PM
Lyrehca - I rec'd the receiver from Dexcom gratis, so the sensors were my top priority at the moment. I'm now working to confirm what else, if anything, is covered. Small steps, but important ones at this juncture.
Posted by: Kerri. | October 3, 2008 04:42 PM
congrats. I know I'm preaching to the choir, but tighter control is so much easier with CGMS. Yes, mine annoys me at 3am frequently, it's infinitely better than waking up at 5am with the wobbles.
Posted by: Emericle | October 3, 2008 04:44 PM
SUPER!!!!!!!!!!!
Posted by: Ronda Darling | October 3, 2008 04:45 PM
Kerri, thanks for the fast response. Since I haven't wanted a CGMS because of the insurance issues, I don't know these details.
But is getting the receiver gratis like getting a glucose monitor (i.e., easy to get for nothing) because the sensors are where the companies make their money? Or did you get it gratis because of your connections? If so, how much is the typical cash outlay for a receiver and do you see the insurance companies eventually covering the cost of that as well? And will they reimburse you (unlikely, right?) for sensors you've already used, or is this reimbursement from this point forward?
Thanks!
Posted by: Lyrehca | October 3, 2008 04:56 PM
L - The receiver is about $900, so yes, the sensors are where the money is at ($60 apiece). And yes, I received it gratis due to personal connections within the company. However, insurance companies do approve the whole package, so that wasn't a deciding factor. Also, this approval is retroactive, so any sensors I've paid for in the past are reimbursable.
:)
Posted by: Kerri. | October 3, 2008 05:11 PM
Yippee!!! You did it, you outlasted the bloodsuckers, err..I mean insurance company. Way to go. You gonna frame that letter?
Posted by: Carol | October 3, 2008 05:13 PM
That's terrific, Kerri! Congratulations. Nice to see when hard work pays off.
Posted by: Allison Blass | October 3, 2008 05:15 PM
Yeeeehaw! Thrilled for you.
Posted by: elsimom | October 3, 2008 05:39 PM
Congratulations!
Also, for Lyrehca: IIRC, the Abbott reps at Saturday's ADA Expo stated that the Navigator receiver would run about $1400, and the 3-day sensors $240 for a set of 6.
Posted by: tmana | October 3, 2008 05:46 PM
It's all about persitence! Hopefully your success will help others as well!!
Posted by: Randee | October 3, 2008 06:23 PM
CONGRATULATIONS!!!
You fought hard, and it paid off. Amazing. Job well done.
Posted by: 'Chelle | October 3, 2008 06:25 PM
Congratulations! Yay! *huge grin*
Posted by: Ky | October 3, 2008 06:50 PM
Congrat's!!!
Posted by: Cherise | October 3, 2008 09:30 PM
Awesome!
Posted by: Kathy | October 3, 2008 09:34 PM
Congratulations!!! I am so happy to hear this wonderful news.
Posted by: Mick | October 3, 2008 09:48 PM
Thats what I have been telling you all this time !! Congrats !!!
Posted by: Joanna | October 3, 2008 09:51 PM
Kerri, your persistence has paid off in a BIG way!! Congratulations to you, for not giving up, not letting the bureaucracy B.S. get to you, and for FORCING them to take a good look at what CGM can do for a person with diabetes!! Way to go!!!
Posted by: Lea | October 3, 2008 09:52 PM
Woo hoo!
So awesome! ;-)
Congrats and thank goodness for your determination.
What a nice weekend gift!!!
Posted by: CALpumper | October 3, 2008 10:13 PM
Grats! I'm so happy for you! I tweeted grats to you today but remembered you aren't following me. LOL.
Posted by: Brian | October 3, 2008 11:28 PM
CONGRATULATIONS KERRI! That's excellent! :)
Posted by: Sarah | October 3, 2008 11:29 PM
Oh, I'm so happy for you. That is truly fantastic news.
Posted by: Major Bedhead | October 3, 2008 11:43 PM
Congrats and it is so deserved!!!
Posted by: karend1 | October 3, 2008 11:54 PM
This is WONDERFUL!!
Congratulations, Kerri!
We'll be looking at a CGM in the next few months. This post gives me hope that we might be able to (finally) get this thing for Joseph.
Awesome, just awesome.
Posted by: Sandra Miller | October 4, 2008 12:49 AM
i'm finally home, and although i heard this news HOURS ago (love IM!), i just want it in print that i'm excited beyond words and you deserve MAJOR CONGRATULATIONS.
also, a big HAHA FUCK YOU to Mark who was such a downer the other day about this happening!
Posted by: landileigh | October 4, 2008 01:28 AM
Congratulations!!! You winning this battle, is really a win for all of us. Thanks for being a continuing inspiration to fight. :)
Posted by: Jessica Phillips | October 4, 2008 01:30 AM
Awesome! So glad all the appeals finally paid off.
The retroactive part is particularly cool. I'm just glad to be covered at all, but I'd love to be able to claim back everything I paid in the past.
Posted by: Caro | October 4, 2008 05:18 AM
YAY!!!!!!!!!!!!!!!!
Posted by: Samantha | October 4, 2008 08:42 AM
Kerri, I'm so happy for you! Truly, persistence does pay off.
Posted by: Natalie | October 4, 2008 10:18 AM
I'm really happy for you, Kerri!
Posted by: MelissaBL | October 4, 2008 10:31 AM
it worked! amazing! i'm gonna keep calling and writing about getting a pump, maybe i can get them to do it. :) you're the inspiraaaatiooon....
Posted by: Ashley | October 4, 2008 11:49 AM
Hey Kerri,
I've read your site for a while and really admire your positive aditude. I don't have diabetes, but I have other chronic health conditions....I also know how hard insurence companies can be to deal with. This is awesome! Good for you for being persistant!
Posted by: Melissa | October 4, 2008 02:37 PM
yay kerri!!!!!!! CONGRATS. your fighting paid off, finally. =]
Posted by: Jenna | October 4, 2008 08:32 PM
Congrats Kerri :) This is so awesome and all that hard work fighting the big bad insurance company worked!!! YAY!!!!
Good for you and a big pat on the back for persistence :D Now hopefully they'll take other requests for coverage into consideration ... (wishful thinking??)
Posted by: Jamie | October 4, 2008 11:53 PM
Kerri, That's fantastic! I'm thrilled for you!
Congratulations!!
Posted by: Kate_Ireland | October 5, 2008 11:40 AM
YAY
I was at Epcot this weekend so I just saw this. How exciting for you! I agree with Cara that it must have had something to do with the memo line of your check! :)
Posted by: Sara | October 5, 2008 11:45 PM
For some reason, this makes me want to cry. I think, in part, because there are so many of us with chronic illnesses, of which diabetes is just one, and it does seem like we are at war with the insurance companies. We just waged a battle with out insurance company over coverage of my anesthesiologist for my c-section. he wasn't in plan and, therefore, they weren't going to cover him. Like I had a choice to choose the anesthesiologist for my surgery! Congratulations on your news and let it be one step to getting others coverage.
Posted by: Tammy | October 6, 2008 09:20 AM
AWESOME!!!!! Just goes to show that all the fighting can be worth it in the end. Good for you!!!!
Posted by: Karen | October 6, 2008 09:35 AM
FAN - TASTIC!!!
Posted by: Johnboy | October 6, 2008 12:29 PM
comment number ?...it shows, that lots of people know about SENSORS, hurah ...advocacy at work !!!
I am a Canadian, living with type 1 for over 25 years ( and on Buzz's Disney World Team !!) ...my extended health plan pays for the sensors ...I also am able
to get more than 3 days use out of one ...
CHEERS, N.
Posted by: Nel P. | October 6, 2008 12:45 PM
I know I'm a couple of days late but congratulations Kerri!! I can't imagine how relieved you are. Good work!!!
Posted by: Stacey | October 7, 2008 10:53 AM
Good for you Kerri, you get 11 out of 10 for perseverance.
Posted by: Bernard Farrell | October 7, 2008 11:26 AM
thanks for showing us how it's done!
Posted by: Christine | October 8, 2008 12:05 AM
Thanks for sharing this with all of us. I'm going to start the good fight as well.
Posted by: Dana | October 8, 2008 10:44 AM
Kerri this is incredible news!!!! I am so happy for you and know it will pay off!!! Congrats! - Scott
Posted by: Scott Kasper | October 13, 2008 03:22 PM