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Monday, July, 06, 2009
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Denied for CGM Coverage

Gina Capone
Gina Capone
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Why do we as Americans get denied by insurance companies? Why do we get turned away from hospitals? Why don't we have health coverage for all! Every American in this country should have health insurance coverage for every medical device, supplies, treatment etc..

 

I just don't understand why we don't. Why can't we put a limit on bills that people have to pay? Why can't we get medical devices that will save our lives? Why can't we walk into a hospital without worrying about being slammed by a huge bill at the end of our stay. There are people that go bankrupt and homeless every single day because of outrageous bills from insurance companies. How can we stop this from happening to people. It just does not seem fair.

 

I just wish everyone could have the best possible coverage.  Where we all get top of the line medical devices and supplies. Where you can walk in to a hospital anywhere in the US and see any doctor. No referrals. No hassles. No huge bills.

 

Yea, my wish is probably never going to come true,  I guess that is my own little fantasy world.

 

But, until I wake up from my dream...My wish for right now is to get covered for a Continuous Glucose Monitoring System. I have been denied three times by my health care provider. I have sent all the information that was required and every time.

 

You have been denied because Continuous Glucose Monitors are "Experimental and Investigational" Seriously, can someone tell me exactly what the hell that means? Why if these devices are experimental and investigational that is has just been proven by a JDRF CGM clinical trial to be effective?

 

More importantly what about when I wore a CGM for a week twice. The information that it provided me and my diabetes team helped me make adjustments in my insulin pump that have already helped me lower my A1c from 8.3-7.4. That is huge! I have not been under and A1C of 8.1 in 6 years.

 

Why should insurance deny me for this device? Especially, when the data I recieved from it proves that it worked for me. This device will save me from trips to the ER, complications down the road, hypoglycemia, hyperglycemia and most of all it will help me to have a healthy pregnancy when I eventually want to have a baby.

 

Why does insurance continually deny me for a Continuous Glucose Monitor? Why are other people approved but not me? Am I not severe enough to be chosen? Is my health not as important as another persons? Many people that I have talked to have been denied but are now approved. I am very happy for them, and at the same time jealous. Jealous that they have the chance and I still struggle.

 

I will wait patiently to get my coverage, but, I will not wait silently and without MAKING NOISE. A LOT OF NOISE! And not without help!

 

In July 2008, I started the CGM Anti-Denial Campaign which became an online petition to get 2000 names by November 14, 2008 — World Diabetes Day.

 

I am happy to announce that in 2 months, the petition reached over 2200 signees way before the due date. The petition will be sent to all major Health Insurance Providers Medical Directors. Those are the people that make the decisions. I am going straight to the source. Its the only way to do it!

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