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

[gary melconian]

Its not going to work for me either as I have private insurance that I pay
for through my small practice.   I will be seing how I can get he cgm
covered through my health pprovier health net of California. Hoping thathey
don't deni this one as Ithey have approved everything myendocronologist has
request from afrezza, to trulicity to tresiba .  

-----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' <diabetes-talk at nfbnet.org>
Cc: Bridgit Kuenning-Pollpeter <bkpollpeter at gmail.com>
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. 


_______________________________________________
Diabetes-Talk mailing list
Diabetes-Talk at nfbnet.org
http://nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
To unsubscribe, change your list options or get your account info for
Diabetes-Talk:
http://nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/gmelconian619%40g
mail.com