6 Comments

Perhaps it would be good to bring patients with you when you testify. I would be keen to do it.

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After reading your attachment, it seems like there is a lot of work to do on this topic. And it is well overdue.

I sincerely wonder how to get it the attention that it needs.

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educate people

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Can someone advise me concerning an appeal process? I appealed a decision from our Medicare Advantage insurance that they won't pay for the continuous glucose monitor that my doctor prescribed because I am not on insulin and can't prove that my blood glucose ever went below 54 mg/dl which is impossible to prove because you are unconscious with a blood glucose that low. only a CGM could show that the reason for fainting was hypoglycemia. I have fainted several times in the past few years and am unable to take the oral hypoglycemic medications due to severe side effects including metabolic acidosis and sustained an arm fracture and head injury from fainting. I must control my blood glucose with diet and exercise. Because my blood glucose can spike and crash in less than one hour, It is impossible for me to stick my finger every hour, particularly with the blurred vision that comes with fluctuating blood sugars.

I appealed twice and the third time Maximus overruled the insurance company. But the company appealed again and so now I must appeal to an administrative law judge. I am 74 years old and can't afford the CGM sensors on my own. We couldn't afford the Medicare copay and that is why we switched to the Medicare Advantage Plan. Unless the company is hoping I will die, it should be cheaper for them to allow me to better manage my blood glucose and avoid complications like fractures and head injuries. Any suggestions?

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Unfortunately there is no recourse with Medicare advantage, which is why we tell everyone to stay away from it. Try the American diabetes association. They might ha w assistance or know an org that can help you. Also make sure your state & federal electeds know what is happening to you.

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I read the attachment, great work!!

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