[Diabetes-talk] Clarification for CGM grant

Fri Oct 7 03:00:53 UTC 2016

This happened to me too this year. I always used Novolog, then suddenly, I
was being charged full-price at the chemist. Come to find out, United
Healthcare no longer covers Novolog. Ridic, if you ask me.

Bridgit

-----Original Message-----
From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
blindhands--- via Diabetes-Talk
Sent: Thursday, October 06, 2016 9:39 PM
To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
Cc: blindhands at aol.com
Subject: Re: [Diabetes-talk] Clarification for CGM grant

As of January first this year my insurance stopped paying for my Novalog and
I didn't know anything until I was running low and called to check why the
pharmacy didn't fill it.  I was steaming as I wanted to know why I was not
contacted from the insurance company not covering it after January 1, whi
the pharmacy didn't contact me when the insurance company wouldn't fill my
prescription.  I am on an automatic refill and I was left out in the far
field and no one let me know until I called up and asked where is my
insulin?  I just did not realize I had none left and what was there was just
Lantis.

Seriously I think you are right.  They refuse paying our medications and
tell us we can't get what we have found and the doctor has figured out the
right balance, they thust want us folks to peal over and die when we hit 65.

Joyce

-----Original Message-----
From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Veronica Elsea via Diabetes-Talk
Sent: Thursday, October 6, 2016 4:52 PM
To: 'Diabetes Talk for the Blind' <diabetes-talk at nfbnet.org>
Cc: Veronica Elsea <veronica at laurelcreekmusic.com>
Subject: Re: [Diabetes-talk] Clarification for CGM grant

Wow Joyce. I can tell you that when I've attended some diabetes seminars,
when it came to the tech panels, the people who walked out in tears were me
and the Medicare recipients. This is way beyond ridiculous. And on the other
end of things, I heard a story on the news the other day about insurance
companies deciding not to cover some expensive medications beginning in
2017. It turned out to include Novolog and Lantos insulin. Man, is there
someone up there just wanting all diabetics to drop dead and get out of the
way? Anybody say, right to life? 
To you Joyce, first let me say I'm sorry to see how close you came to
qualifying. I suspect they're going to have to change their criteria or
they're going to lose that grant money soon. Good grief! 
At least if groups like these keep making noise, maybe we'll see some change
happening. Wow!
Hang in there everyone and thank you all for being here.
Veronica

"Guide Dogs, First Hand", Veronica Elsea's classic album is now available on
iTunes, along with other music from her and from the Guide Dog Glee Club. 
To learn more, visit:
http://www.laurelcreekmusic.com
                Veronica Elsea, Owner
Laurel Creek Music Designs
Santa Cruz, California
Phone: 831-429-6407

-----Original Message-----
From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
blindhands--- via Diabetes-Talk
Sent: Thursday, October 06, 2016 12:27 PM
To: 'Diabetes Talk for the Blind'
Cc: blindhands at aol.com
Subject: [Diabetes-talk] Clarification for CGM grant

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

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