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  • Activity
    • 5 hours, 36 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I’m almost always more informed of the reported advancements in T1 treatments than my doc. So I usually bounce ideas off the doc for his input.
    • 5 hours, 37 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I am my own advocate. I read about new devices and always investigate side effects of any new medication before starting. I usually bring up but then have good discussion with Endo before making decisions.
    • 5 hours, 38 minutes ago
      ConnieT1D62 likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      With my endo, I usually have to ask. With the Diabetes Educator, she'll make the suggestion first. They're both very aware that I'm dependent on insurance covering the majority of the cost.
    • 6 hours, 51 minutes ago
      Trina Blake likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 6 hours, 57 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      No, I was the one who had diabetes
    • 6 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 6 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      Already married over forty years when I was diagnosed.
    • 6 hours, 58 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I never knew of anyone who had diabetes, type 1 or 2 before I was married. I became a T1D after I was married.
    • 7 hours, 2 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I answered “no.” I don’t think my girlfriend at diabetes children’s camp when I was 13 counts. While I think there would be a lot I would have in common with a partner with T1D, I wouldn’t want that to be what brought us together, and I don’t think it would keep us together.
    • 7 hours, 2 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      went on one date with a T1D. she had been dx'd as a child (I was dx'd at 43) so she was very old school. she ragged on me during the entire date about my menu choices, my carbs estimation for my shot and she lost her mind when I ordered a Corona! punchline is that my sugar was less than 150 when I went to sleep.
    • 7 hours, 3 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      When I was married, diabetes was not in the picture at all. All I knew was an uncle who died in 1929 because he refused injections. I developed LADA in my 40's, followed by my husband with Type 2, then my two daughters who had PCOS and Type 2, then my son with Type 2. Enough.
    • 7 hours, 3 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I am married to someone with Type 2.
    • 7 hours, 3 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I have been married since 1985. My wife Susan does not have either type 1 or 2 diabetes, but rather type 3 diabetes- spouse or mate of someone with T1D...:) She has been my guardian for night lows, though she has rarely had to intervene since I started CGM in 8-2006.
    • 7 hours, 3 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I dated someone, but I was/am not out of the closet about having T1 so he didn’t know that I have T1
    • 7 hours, 3 minutes ago
      beth nelson likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      My husband was diagnosis at age 3 and I was diagnosed at age 4.
    • 7 hours, 24 minutes ago
      Janis Senungetuk likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 7 hours, 25 minutes ago
      Janis Senungetuk likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I think my healthcare providers learn about new medications and devices at about the same time that I do. This wasn't the case when I was first diagnosed, pre-internet. Back then, I always looked forward to seeing my CDE because I knew I'd come away with something to make my life easier/better.
    • 7 hours, 44 minutes ago
      Bonnie Lundblom likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I have been married since 1985. My wife Susan does not have either type 1 or 2 diabetes, but rather type 3 diabetes- spouse or mate of someone with T1D...:) She has been my guardian for night lows, though she has rarely had to intervene since I started CGM in 8-2006.
    • 7 hours, 53 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I may already be on the best medications and devices available to me.
    • 7 hours, 53 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I wouldn't say that my T1D healthcare provider OFTEN suggests medications or devices that they think would be beneficial to my diabetes management, but they do SOMETIMES suggest options available to me. (I was privileged to be the first person, in the area that I live, to be offered CSII (Continuous Subcutaneous Insulin Infusion, or pump technology) to help control my diabetes. This was after my endocrinologist attended a diabetes conference in the United States where a former Miss America, Nicole Johnson, was demonstrating a Medtronic/MiniMed insulin pump. He asked her for more information on how these pumps work, mentioning that I had extreme difficulty in controlling my diabetes, with me spending as much time in hospital as I was at home when I was taking multiple daily injections (MDI). On his return to the UK, he offered me the opportunity to 'trial' the pump, which I accepted. This was in 1989.)
    • 7 hours, 54 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I think my healthcare providers learn about new medications and devices at about the same time that I do. This wasn't the case when I was first diagnosed, pre-internet. Back then, I always looked forward to seeing my CDE because I knew I'd come away with something to make my life easier/better.
    • 7 hours, 54 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I had to answer “other” because I just got a new endo after my other one retired so I’ve only met with him once. Too early to discuss new technology or medications.
    • 7 hours, 54 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      Generally, no, my healthcare provider does not suggest new medications or devices. However, it is not often that new meds/devices become available. Most things are dependent upon my quarterly blood tests. Recently, my Endo put me on statin drugs when my bloodwork showed high cholesterol over a six month period. Otherwise, I am usually the one who asks about new devices about which I have heard or read.
    • 7 hours, 54 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I’m almost always more informed of the reported advancements in T1 treatments than my doc. So I usually bounce ideas off the doc for his input.
    • 7 hours, 55 minutes ago
      beth nelson likes your comment at
      Does your T1D healthcare provider suggest new medications or devices that they think would be beneficial to your T1D management during your appointments?
      I am on the Dexcom, I’m not on a pump though. I am LADA so I have very high insulin resistance, so I use a lot of insulin & there’s just not a pump that would be efficient for my amount of insulin. I’ve tried to get Afrezza, but every Endoc I bring it up to won’t prescribe it. Even though I bring them evidence that it doesn’t cause lung cancer when you’re not a smoker. So frustrating that we can’t agree on that course of treatment.
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    If you use an insulin pump, have you ever received a denial from your insurance company, notifying you that the costs for your pump and/or its supplies will not be covered? If so, what was the reason? Please select all that apply to you, and share in the comments about your experiences.

    Home > LC Polls > If you use an insulin pump, have you ever received a denial from your insurance company, notifying you that the costs for your pump and/or its supplies will not be covered? If so, what was the reason? Please select all that apply to you, and share in the comments about your experiences.
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    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    20 Comments

    1. Ms Cris

      The PA is required once/year…even though T1D is incurable.

      The first time it happened, I had just been diagnosed, learned the ins/outs. Now it’s automatic and I have this year’s ready to go for my Dr as I type!

      2
      5 months ago Log in to Reply
    2. Jen Farley

      This was from back in the day when pumps were new. I had to have an endocrinologist verify it was medically necessary. Took some time to find one, but I did. Then the paperwork was insane and was still told I could get a rejection. My A1C was bad and finger prick tests did finally win over the insurance company and I did receive a pump. I am glad the process has become easier, I just know I have to wait until a medical device is something that has been shown to work and is a normal procedure for the diabetic community. The last time I went through this was the closed loop system. My endocrinologist now is a master at getting things taken care of so it is less stress on me.

      5 months ago Log in to Reply
    3. Lawrence S.

      I probably clicked the wrong response. But, as I’ve told before, I was denied getting a CGM by my insurance company around 2006. I was told it was not a covered item. Soon afterward, I collapsed from a low blood glucose and broke my ankle. I called the insurance company while I was sitting at home in a cast. I told them that I probably would not be home from work, costing them thousands of dollars if I had a CGM. Soon afterward, I was approved by the insurance company for a CGM. I may have been the first person approved for a CGM by my insurance company (I can’t prove that).

      2
      5 months ago Log in to Reply
    4. Kevin McCue

      UnitedHealthcare had an exclusive contract with Medtronic barring my request to get Tandem pump. I was able to get Dexcom Sensor at least and get away from that ridiculous Threshold suspend on the very unreliable Medtronic sensor. Changed to Blue Cross Blue Shield to get Tslim. Now Dexcom/Tandem combo is working well with the CIQ. Much better control.

      2
      5 months ago Log in to Reply
      1. Amanda Barras

        Same! I was so mad, and my doc didn’t want to hassle with the paperwork to fight it. I don’t blame her, I know she knew it would have been a futile effort. But insurance changed and I have been happily on Tandem for 2 years now.

        1
        5 months ago Log in to Reply
    5. Sondra Mangan

      As of January 2023, just about one year after the FDA approval of Omnipod 5, Tricare has not yet approved coverage of the newest model for military families. It was presented at a closed meeting in November and we may find out in February if it is approved—and then will wait another 60-90 days for it to be added to the Formulary.

      5 months ago Log in to Reply
      1. Amanda Barras

        Back in 2007 I wasn’t allowed to add the CGM to Medtronic’s system while on Tricare because it wasn’t medically necessary either. Didn’t add CGM to my care until 2012 when separated and had good medical insurance through my husband’s new job.

        5 months ago Log in to Reply
    6. Abigail Elias

      My doctor had to provide detailed info to justify the necessity of my first pump (1990s), such as work hours, dawn phenomenon hypoglycemic episodes or done thing like that, juggling a couple of toddlers, etc., which hasn’t been necessary since then. However, when I started with health care coverage under Medicare (USA, when I retired), I had to prove I had T1D to get coverage, despite having had T1D for 50+ years with ample medical records to document that history.

      5 months ago Log in to Reply
    7. Jneticdiabetic

      Yes, but not recently, thank goodness. However, when I was first prescribed a pump in 2000, I had to go through several rounds of appeals with the insurance company to justify that it was medically necessary. I wrote a detailed letter essentially saying “is being found unconscious due to severe hypoglycemia requiring glucagon ~4x/yr and an emergency room visit not adequate justification? Finally, convinced them by making the case that a pump was good for us both (reduced risk of premature death for me AND less costly for them). That worked. Have been pumping since Sept 2000.

      2
      5 months ago Log in to Reply
    8. Vivian Moon

      I paid out of pocket for a Tandem pump as Medicare doesn’t pay for new pumps sooner than 5 years. My Medtronic pump had had numerous manufacturer issues and I just wasn’t getting acceptable control. I wasn’t eligible for another 18 months.

      2
      5 months ago Log in to Reply
    9. Marty

      I think I’ve mentioned this before, but my first pump request was denied at first as not medically necessary. They told me it would be cheaper for them to send a nurse to my house every day to give me injections if I had no hands to do it myself. They caved after I told them I’d already paid the copay, which was quite a lot of $$ at the time. That must have convinced them that I didn’t consider it to be a luxury.

      1
      5 months ago Log in to Reply
    10. Trisha Oldenkamp

      The Omnipod pump intro kit was “not covered” but the Omnipod’s are! I jumped hoops with help from Insulet for 6 months and finally received an insurance override. It shouldn’t be so hard!

      1
      5 months ago Log in to Reply
    11. Julie Nalibov

      I checked “yes” because they UNDERSUPPLY me. I get exactly 10 infusion sets per month. And fairly often, one either is irritated after 2 days, gets accidentally pulled out, goes in incorrectly, has to be changed early or I ruin it while trying to insert it with the delicate multipart procedure of unwinding the tubing, removing swivel tape, etc. of TANDEM) I have zero slack unless I wear them for 4+ days. Frustrating and stressful. If you call for replacement, its a long phone call and a week later, a giant box with one replacement (so much environmental waste!!). Dr. tried to write prescription to change every 2-3 days but alas insurance said NO.

      1
      5 months ago Log in to Reply
    12. Amanda Barras

      Yes – not Medically Necessary – back in 2007 when I started with Medtronic the CGM portion was not medically necessary and not covered by insurance.
      Yes – had’t seen my provider recently enough. 2 months ago I tried to reorder supplies, they needed a new Rx and chart notes. My chart notes were more than 6 months old so I had to get an emergency virtual appt and labs drawn to update notes before prior auth was issued and supplies sent.
      Yes- pump brand not covered by insurance. Back when UHC was exclusively “in-bed” with Medtronic they would not authorize a switch to Tandem because it was not a covered device.

      1
      5 months ago Log in to Reply
    13. BARRY HUNSINGER

      When I switch from private insurance to Medicare I was denied coverage. I had to prove to them that after almost 30 years that I was actually a type 1 diabetic and I had had that test back in the early 90s which proved it but I had to do it all again. it took 3 months to get it straightened out

      5 months ago Log in to Reply
    14. PamK

      I have had several of these reasons occur. when I first got a pump the insurance initially said it was not medically necessary. As time has gone on I’ve had insurance companies tell me that the brand/model I was using was not covered. One time more recently, I was told that I had not seen my endocrine recently enough, even though he had submitted a new prescription for me! I have needed a Prior Authorization every time my insurance has changed over the years except once! I also have had “clerical errors” (I forgot to check that one!) with my current insurance. They told me my pump/CGM were not covered when I had just received a letter in the mail telling me that they were, with Prior Auth. which had been approved. I guess it wasn’t in the system yet!

      5 months ago Log in to Reply
    15. Mick Martin

      I selected “No – I have never been denied coverage for my pump or its supplies” but this MAY be misleading. I live in the United Kingdom of Great Britain and Northern Ireland where all of my diabetes supplies are paid for by our NHS (National Health Service), which is financed via direct taxation of all working people.

      5 months ago Log in to Reply
    16. Jillmarie61

      It was a long time ago, 1979-80. It was deemed experimental and they refused to pay. My parents sued and it was ruled in their favor. Since then I don’t ever remember having an issue.

      5 months ago Log in to Reply
    17. Lenora Ventura

      I said yes, it was deemed not medically necessary. Some background detail’s important here: this was back in 1998 with my 1st insulin pump. The Minimed 507c. I had a HMO at the time and had to file an appeal which included pictures of my bruised abdomen among reports of the toughness on my arms & legs that prevented the continued use of MDI. After a lengthy fight, it was finally approved. Every pump since has been a piece of cake in comparison

      5 months ago Log in to Reply
    18. Jeff Balbirnie

      A long time ago when I used a pump, but it was a severe comedy of on going ever changing pathetically untrue errors.

      My favorite was in necessary.

      1
      5 months ago Log in to Reply

    If you use an insulin pump, have you ever received a denial from your insurance company, notifying you that the costs for your pump and/or its supplies will not be covered? If so, what was the reason? Please select all that apply to you, and share in the comments about your experiences. Cancel reply

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