[Diabetes-talk] Help for those denied CGM coverage.

[Veronica Elsea]

I suspect that with limited funds, they're trying to cover those at the most
extreme end of the spectrum. But boy, for those who do, what a gift. I'm
also glad to see them going after Medicare big time.
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
Bridgit Kuenning-Pollpeter via Diabetes-Talk
Sent: Thursday, September 29, 2016 3:24 PM
To: 'Diabetes Talk for the Blind'
Cc: Bridgit Kuenning-Pollpeter
Subject: Re: [Diabetes-talk] Help for those denied CGM coverage.

I went to the site and found the rules for those interested. Based on this,
not just anyone qualifies. For me, for instance, will not, especially with
number one, I have no problem knowing when I'm low:

1.Have diabetes requiring multiple daily injections or insulin pump therapy
with hypoglycemia unawareness (the inability to recognize when your blood
sugar is too low).
2.Have had private health insurance coverage for CGM before transitioning to
Medicare.
3.Have been denied coverage for a CGM by Medicare, filed a request for
redetermination (the first level of appeal), and been denied again.
4.Be able to include a copy of the redetermination decision letter from
Medicare denying the first level of appeal.
5.Have a physician willing to sign a statement of medical necessity
6.Have medical records that can be submitted in support of the Medicare
appeal if requested.
7.Agree to have their favorable Administrative Law Judge decision shared and
added to the administrative record on appeals. The purpose of this request
is to send a message to Medicare that this is an important issue and affects
many people.
8.Have gross annual pre-tax household income below the median income in your
state for a household of the same size. 


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