Disappointing Diabetes Day

angryThere are times in your life where you really wish you didn’t have to admit something, but you sort of have to because eventually people are going to start asking questions.

So here it goes:

Last Tuesday, as I was finishing up a much-needed post-semester massage, I received a call that my insurance company, Cigna, was requiring that I have a C-peptide test done in order to approve my request for the Omnipod. For those of you who don’t know, a C-peptide test shows whether or not you are making any insulin. Considering I have been a type 1 diabetic for almost 20 years, and have 20 years worth of A1C results, co-pays for endocrinologists appointments and diabetes supplies, and, you know, another insulin pump, I find this request borderline insulting. Do they really think I’ve been making up this diabetes business for twenty years for shits and giggles?! I mean, really…

I have to get my labs done anyway, so I’m trying to not be too annoyed, but it’s putting a delay on my Omnipod order which is why I haven’t mentioned going on it yet. I should get it sometime in July and then I’m hoping to have Gary Scheiner train me when I go to AADE next month (or, you know, one of the other 10,000 CDEs who will be there, including my roommate, Kelley Crumpler!).

Having to get a C-peptide test is more of annoyance. The real tragedy is what follows:

I lost my Dexcom G4 transmitter.

Or better yet: I probably threw it away. I was at work a couple weeks ago when the sensor felt particularly itching and annoying. It was in fact getting a bit infected, which I have a history of with Medtronic but so far not with Dexcom. Rather than put up with the itching, I ripped the damn thing off. And promptly threw it away. Without, you know, taking off the transmitter first. Since I was getting a massage done a few days later, I decided to forego putting another sensor on, which is why it was a good four days later that I realized I no longer had my transmitter.

I called Dexcom and the rep told me they would replace the transmitter — hold your enthusiasm — for a mere $199. Yikes. Apparently some folks have their transmitters replaced by their insurance company, but it isn’t very likely. I haven’t decided if it’s worth the fight or if I should just hold off for another two and a half months until my warranty runs out and I’m eligible to submit for a new one. Considering they are forcing me to get a C-peptide test to approve an insulin pump, methinks my chances are not very good.

I’m irritated by the C-peptide request, and I’m just plain mad at myself for losing the stinking transmitter. But most of all, I’m mad at diabetes for adding even more stress and to-dos in my life. As if I don’t have enough going on!

8 thoughts on “Disappointing Diabetes Day

  1. Aw, I’m sorry you have had a rough week…I know too well how those go. I have never heard of needing to get a C-peptide test before to get approval for an insulin pump-how crazy! Hope all goes well with getting your transmitter replaced! At least you had a nice massage last week! :)

  2. I hate having to fight insurance companies for the stuff that we need. I’m currently in the appeals process to get my Dexcom replaced. They don’t want to pay for a new system but had no issues paying for the old sensors. It’s like they think we do this stuff for fun… (stuff being sticking ourselves with needles, poking our fingers and filling out loads of paperwork).

    I hope your tests come back quickly and you can get your OmniPod!

  3. I caution you on waiting to order the transmitter. So much will depend on how your insurance covers the DexCom and it’s parts, but you may end up paying WAY MORE once the warranty has expired. My personal experience was that my transmitter died (they are only under warranty for 6 months) and so I had to order a new one. I am on a benefit plan where I pay 20% once I’ve met my deductible. DexCom sent a claim to my insurance for $1,550 (yes, you read that right…that’s just for the transmitter). My health plan got $930 worth of discounts (this will completely depend on your insurance, the contract they have with DexCom, etc.)…leaving a blance of $620. Had I not met my deductible, I would have had to pay the full $620. I’ve already met my deductible, so my portion was $124 (620 x .20). I would have rather bought a new outfit. I suggest you figure out how your insurance would cover it once it’s not under warranty as you may find that $199 is peanuts compared to the horror you’d be faced with. Here’s my blog post about it: http://www.diabeticadvocate.com/2013/06/dexcom-g4-dont-forget-about-transmitter.html

    • My understanding is that insurance companies are supposed to cover the transmitter 100% (after the copay) after you reach your deductible. I had a higher cost for the first transmitter because we had not yet met the deductible. The question here is whether or not the insurance company would even accept a request for reimbursement from Dexcom, or if it would be immediately denied. Since the second transmitter would be purchased within the same calendar year, I’m not expecting it to be more than $199. But you do make a good point that it’s always worth checking out all the options and this is something to consider. Thanks!

  4. I had the same thing happen where I thought I threw the transmitter away. Was falling asleep on the couch and woke up around 1 am deciding to throw away my mess. Not thinking to make sure transmitter wasn’t attached. Ugh. Had only had it a few weeks. Ended up having to pay the $199. Rough way to learn that lesson. Now I make sure any time I pull it off to put it in a safe spot. Turned out that a few months after the trash incident I was moving around my living room. What do I find under the entertainment center? The transmitter! Ugh I didn’t throw it away. Must have fallen off of me when I was startled awake. I had looked under under the couch, the cushions, all over the floor, but tv stand is so low to ground you can’t really see under all of it. There it was in the hidden spot. Talk about frustrating. The fun things we deal with.

  5. This must be an Omnipod thing with the C Peptide request. I have been a diabetic for over 35 years and wore 4 previous pumps and yet I had to do this lab as well this past couple of weeks to get approval. I had to kind of chuckle because my Dr has a new nurse and she phoned me after the labs and confirmed for me that the tests did indicate I was a Type 1 – like this was news to me. Looking forward to the Omnipod switiching from the Revel and also starting with the Dexcom (having used Medtronic’s CGM for over five years).

    • The woman from Insulet actually called me to tell me that Cigna was the one that needed the C-peptide test. She apologized that I needed to do this and said that it was common of Cigna. Perhaps Cigna is not the only one to make these ludicrous requests?

  6. Pingback: The Proof Is In The Lab Report | The Blood Sugar Whisperer

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