If you’re living with diabetes or have been recently diagnosed, you surely have questions and concerns about this chronic condition. This is the next installment in a series of frequently asked questions about diabetes, with answers from a Spectrum Health team of doctors, nurses and dietitians.
Question:
I recently started wearing a glucose sensor that’s linked with my insulin pump. Do insurance companies cover these units together?
Answer:
Different insurance companies have different benefits, but we’ve found that most commercial insurance companies cover these linked devices.
Of the companies that do cover it, coverage can range from 50 percent to 100 percent of the cost, depending on what your employer purchased or what you chose to purchase. This is why it’s always important to ask your insurer, “What do you cover related to diabetes?”
Insulin pumps are considered durable medical equipment–they’re not a pharmaceutical benefit. Usually your reimbursement will follow whatever your durable medical equipment policy says: 80/20, perhaps, or 90/10, which means you’ll pay the smaller portion of the cost.
Question:
What about Medicare coverage?
Answer:
Programs that have federal or state funding, such as Medicare or Medicaid, do not cover continuous glucose sensing. They pay for test strips and testing, and they’ll pay for the insulin pump, but not the continuous sensors. If you’re disappointed with that, write to your congressional representatives because they have the ability to change that.
An important note here: Because diabetes is a self-managed disease, it’s really important to learn and practice lifestyle skills that will help control your disease. Education should be ongoing because diabetes can change and affect you in ways that it didn’t before changing. Those changes often require more education.
This is very important because the Medicare education benefit is underutilized–only about 2 percent of those on Medicare actually use their Medicare benefits for education.
At Spectrum Health, we host diabetes classes at four locations throughout the greater Grand Rapids area. We have eight diabetes educators, who are either nurses or dieticians, that offer diabetes support group meetings and free pre-diabetes classes.
provide me with you diabetes classes info and an info on the names of your dietitians and their phone number
please let me know what classes/support
groups you have for pre-diabetes.
thank you