CGM – Now you can have it….but one day, you can’t.

I don’t know about you guys, but I live and breathe by my Dexcom CGM. Since acquiring it a few months before getting pregnant, I’ve learned (mostly) all it’s quirks, and rely heavily on the trends and readings when making decisions about what I eat, when to eat, when to take insulin, when to NOT take insulin, and when to participate in activities – like exercise, or even driving. I can’t tell you the number of times it’s stopped me from doing something stupid.

Prime example: Before my CGM, I would “assess” how I felt when getting in the car to drive. If I thought there was a chance I MIGHT be low, I would check my blood sugar on a finger-stick meter. It might tell me something great, like 100. So, I’d get in the car and drive. Imagine my surprise when, less than 10 minutes later, I’m feeling dizzy and woozy, and luckily have stopped in a parking lot, check my sugar, and it’s 55. IF I had only had a CGM at that time, it may have shown me that my sugar was 100, but with an arrow trending down. Or showing me double down arrows which means REALLY going down fast. In that case, I would have never gotten into the car and risked a crashing blood sugar while driving. Over the years, I’ve steadily lost some sensitivity to low-sugar awareness. Sometimes, I still “feel” it….but a LOT of times, I don’t. As I type now, imagining life without my CGM? Imagining being in a car with my daughter and a low sugar coming out of nowhere with no warning? Going to sleep one night thinking everything was fine, when it really wasn’t? Well, let’s just say, I don’t want to even think about it.

Sue from Test, Guess and Go is waging a war for her husband….trying desperately to get his CGM covered under Medicare insurance. Below is a guest post from her – please read, and act!! One day, it could be you or I without the CGM…..

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Sue Berger from PennsylvaniaI am the wife of a diabetic. I’ve said and written these words so many times, that they seem to now define me. I sometimes feel as if I’m losing my own identity. This journey for me started around 1 ½ years ago. My husband, Marc, who has Type 1 diabetes and hypoglycemia and hyperglycemia unawareness, had been using a Continuous Glucose Monitor (CGM) for approximately five years and it had always been covered by the group insurance from my husband’s place of employment. In June of 2012 he turned 65 and had to go onto Medicare. A few months after that, the CGM he was wearing started to become very erratic. His doctor wrote a prescription for a new one but his supplemental insurance company, Highmark Freedom Blue, denied payment. We began the long process of Appeals.

Long, long story very short…. many phone calls ensued, doctors testified as to Marc’s need, tons of evidence was presented showing the medical need for the CGM….only to receive an UNFAVORABLE decision from a judge in February this year, basically saying no, his supplemental insurance would not pay for Marc’s CGM, and it was not covered under Medicare.

In December of 2013, Congresswoman Carol Shea-Porter (D-NH) introduced a bill into Congress. H.R. 3710 provides for coverage of a CGM by Medicare if recommended by a physician. I have been in touch with her Legal Assistant, Marjorie Connolly, and Representative Shea-Porter is doing a big push among her Colleagues asking for them to sign onto this bill.

If you go onto www.testguessandgo.com you will see my blog entitled “Join the Crusade”. At the bottom of the blog, you will see links to download a sample letter to write to your Congressperson asking him/her to support the bill. You will also see Congresswoman Shea-Porter’s letter to her Colleagues.

Why is this issue so important to me? The obvious reason is that I dearly love my Marc.

For the past year, Marc has been without a CGM and there isn’t a day that I’m not filled with anxiety. He’s had many close calls while driving and it’s only by the grace of God that he hasn’t injured himself or someone else. He’s a courier and spends a lot of time in the car and has had some pretty close calls. Our children both live in Atlanta (we live in Harrisburg, PA) and I used to be able to visit them regularly and now I have to make sure that he can take time off from work to go with me because there is no way that I would leave him alone all night. The worry is with me, and him also, 24/7.

During the time that I have been fighting for coverage of the CGM, I have encountered many other men and women who are in the same situation as Marc is in and need a CGM but can’t afford the out-of-pocket cost of the device and sensors. None of these people ever thought that after having a CGM covered for so many years by private insurance, that Medicare would not cover it. I have also met many men and women who will soon be entering the system, are presently covered by their private insurance and are worried that they will not be able to get a CGM or sensors once they go onto Medicare.

This issue is so important and the only way to change the Medicare guideline for the CGM is to put pressure on our Congresspeople asking them to vote YES to H.R. 3710.

Recently, a group has been formed on TuDiabetes called the CGM Reimbursement Advocacy Group. http://www.tudiabetes.org/group/cgm-advocacy. The purpose of this forum is a place to try to gather interest in CGM Advocacy; to share information about CGM efforts, craft common messages, link useful research and connect individual advocates.

Also, if you go onto https://www.popvox.com/bills/us/113/hr3710 you can click on Support, put in your name and email address and a notification will be sent to your Congressperson showing that you support H.R. 3710. There are comments from diabetics, wives, children and friends stating why they support the bill. I find them extremely interesting to read.

Won’t you please take the time to do these things? I can’t stress the importance of raising up our voices loud and clear and letting those in Congress know that for those who need a CGM, it’s a matter of life or death.

Thank you,

Sue Berger – writer/contributor at http://testguessandgo.com

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