[Diabetes-talk] Clarification for CGM grant

[blindhands at aol.com]

I sent all my information in for that place that had received grant money
for the Medicare not covering CGM and supplies.  And I spoke to them on
Wednesday.  I wanted to give everyone an update.

The funding is to cover an attorney that will handle the third step of an
appeal against Medicare for coverage of a CGM and the supplies.  So you have
to have the first two denials from your insurance/Medicare.  The last appeal
goes in front of a judge.

They do not have anyone that meets all the criteria that they are looking
for yet.  They would like to have 50 people on board for this.  I meet all
but one thing.  I did not have  insurance that covered the CGM before I went
on Medicare.  Actually I probably did, but I wasn't trying to get a pump &
CGM before I went on Medicare.  When I was on a pump some 30 years ago,
there was no such thing as a CGM.

Just some notes in case you know of anyone that might meet the criteria.  
Insulin dependent diabetic, multiple injections, can not detect insulin
reactions, limited income [they give per state the minimum you can be
receiving,They ask if you have been in a car accident while driving due to
an insulin reaction[I did that about 20 years back] have any insidents
falling due to insulin reactions[I had broken wrist, broken ankle and broken
5th metatarsil within a 1 year time], confusion, passing out,seizure,have a
doctor willing to write necesssidy need, and doctor note describing
condition of diabetes, blood work showing your pancreas is not producing
insulin and 2-3 months of blood sugar testing minimum 4 times a day.

I provided all of this to get my 2 denials and sent all of this in to be
considered for this judgement.

Right at this moment I don't qualify, but I was told that that if they don't
get enough people they might have to consider changing the criteria, so they
will  keep my records.

What I have read and what has been said, is people who are 65 years old and
older are left out or denied what they had prior to Medicare.  Tha medical
bills for seniors falling due to low blood sugars will cost Medicare a lot
more then paying for CGMs.

So you folks using an insulin pump or not and those using a CGM now and
under better control   if Medicare doesn't change this coverage I feel
Medicare is denying seniors medical services.

With the movement toward the artificial pancreas Medicare will be denying a
medical cure for diabetes thru treatment.  Insulin is not the cure and never
was, but with the technical advancements insulin control might be the cure.

Joyce Kane