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

[Robert Shelton]

Are you sure? I ask because my wife is usually able to tell if she is going
low, even at night while asleep, but if she doesn't catch it in time, then
she's helpless. I've been working on her to get the CGM. It's not going to
replace testing, but it covers those times when you should test and for some
reason, don't. 

-----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 5:24 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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