Oh, insurance… What are you doing?

10 11 2009

I got a letter yesterday from my health insurance stating that they are no longer covering my Dexcom sensors, starting from August. I was confused because they’ve covered them in the past. Based on the code they listed, I assumed I had hit my DME cap for the year (this was my first full year on the sensors) and would need to appeal.

However, after spending 1 hour talking to 5 reps, I found out that the health insurance has randomly decided they are “disposable” since I throw them out after 7 days and they don’t cover “disposables”.  I imagine that “disposables” is intended to cover things like alcohol wipes and cotton balls, which they should rightly not cover.  However, 7 days is hardly “disposable”.

Edgepark (the company that provides the sensors) is already working it and their argument is that they’re not considered “disposable” since they are used in conjunction with a Durable Medical Equipment (the receiver).

I won’t know anything for at least 5 business days, but it is good to know that Edgepark is trying to regain my coverage.  I really cannot afford to either a) pay full price for the sensors or b) limit my use of them to every other week or similar.  I just hope this gets straightened out.

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