Diabetes Blogs

Insurance Insanity!!!

Hi Everyone. This blog may be a bit off the map compared to my usual blogs, but it needs to be addressed. I discuss the complicated process of replacing a lost continuous glucose monitor (CGM). 

A few weeks back during one of the Blizzards, I was on my way to my private practice where a client was waiting very patiently for his diabetes-focused psychotherapy session to begin. One problem, I was running late due to the storm.

I usually leave a half-hour extra just in case, but the trains were not running at all. I was caught off guard because during the past blizzard, which was way worse, the trains ran beautifully.

I have lived with diabetes for over 36 years, and I was not prepared for the insurance insanity that followed.

If you recalled from my previous blog “Living Life on Diabetes Terms,” I talk about this day and how I handled the struggle getting to work. Now, lets look at the insanity in the aftermath of losing my CGM that day.

The Aftermath

I called the supplier, who provided only part of the needed information. They said that I had to get a new script from my doctor and have it faxed to them. 'No problem!', I said to myself and sent an email to my doctors who informed me a day later that they faxed it to the supplier. Great! My CGM should be on its way in no time.

No, it’s just starting. Two days later I get a chance to call the supplier who says that they need a specific form filled out and that they will send it to the doctor. So I call the supplier the following day to confirm that form went out, and they said it did. I didn’t want to bother my doctor, but I should have called them anyway. A week after I started the process—I called the supplier who said they hadn’t received it back, and the doctor’s office says they never received it.

It is now 10 days in and I called the supplier up who said that they received the form back, but there was a problem.

I take a deep breath and ask them what the problem was. This is a very frustrating process, but nothing I haven’t seen before. Keep in mind “during this process” it is important to take care of you, both physically and emotionally.

The Problem: 

“No police report!” “What?” “Come again?” The person on the other end said it again. “Sir, you need to obtain a police report stating where and when you lost it!”

Logically, according to them my word wasn’t good enough unless I tell it to an officer of the law who will then write it up and send a copy to them.

Well, the report is still based off your story to them, police or no police report. The other issue with this process is how do you verify that you lost something or even where you lost it? If you know where you lost it, then it would not be lost.

Once again, take some deep breaths and get all the information you need and try not to think about the logic but that it is a bureaucratic process, and logic doesn’t necessarily apply.

I trek to the police department, and they were absolutely thrilled… to be taking my report. They tell me that I can’t get a copy unless I call back in 24 hours and get the record number first.

I call back. No voice mail! I rinse and repeat for 2 days till I get a human being on the other end of the telephone. “Your police report # is … and you won’t be able to get a copy, you have to give the report number to your insurance company, and they will have to request one.” I thanked her and did just that.

The phone rings! Guess who? You got it! The supplier is giving me a call a few hours after I gave them the number. “Sir the police won’t release the report unless you file a written request to them” I call the police back who said that I needed to, via snail mail, send a written request with 15 bucks for a processing fee, with a self addressed stamped envelope. Crazy, right?

The Solution:

It’s 2 weeks later. I had already spent hours of my time and lots of energy. I stopped there and decided to call Dexcom whom I knew gave a discount if you lost your device. Well, they allow a one-time replacement during the one-year warranty period. Dexcom customer service said that my warranty was up in 3 weeks, or I could purchase a replacement for $200.

I said to her “my health is more important than $200. It’s price-less." So I bought the replacement and submitted to insurance for a new one just a few days ago.

FYI: Most insurance will pay for a new one, once every year so you may want to take advantage and submit for back up after a year has passed. Having duplicates of all supplies and equipment can create peace of mind.

Health Tip:

While not on the CGM, I made sure to do my best to keep my blood sugars under decent control. Remember if you become used to using it, when you stop using the CGM your blood sugars may be in less control than even before you ever used the CGM. There is an adjustment period. So, be kind to youself.  Realizing some things are just out of our control can help with reducing self-blaming thoughts.

Thanks for reading and I look forward to seeing you at the New York Diabetes Expo this Saturday.

This Saturday I will be available to answer questions about Diabetes-Focused Psychotherapy and emotion related topics, at the FREE New York ADA Expo 2014 in New York City. You will be able to find me at DiabeticTalks, Booth Number 425. Feel free to stop by

New York EXPO 2014

When: Saturday, March 15, 2014 10:00 a.m.-4:00 p.m.

Where: Jacob K. Javits Convention Center
655 West 34th Street (Entrance on 39th and 11th Avenue)
New York, New York, 10001

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