theaveragejoepage2 Comments on The Fight With Insurance

The Fight With Insurance

Remember me posting a little while back about insurance declining the insulin pump and CGM (the T:slim X2 and Dexcom)? Well we appealed the decision, and we got a response: a big, fat, 2nd denial letter.

Reasoning

When we got our first letter of denial, they told us that they wanted me on injections for 6 months, but our endo was fine with me getting one now. After hearing that, they changed their reason for denial. Their new reason for denial, even though I’m a calm and reasonable guy just makes me straight up enraged. They now want me to be hospitalized for an emergency regarding my blood sugar before they’ll give me a pump or a single CGM. This means that they want me to be in a fatal situation, just to get a few tools to help me stay alive. Now do you see why I’m enraged.

1918-2
This is a Dexcom. This tiny device goes directly onto my skin and has a very small cannula that goes into my skin. The cannula tests my bodily fluids about every 5 minutes so I can know what my sugar levels are. It even tells me what direction my sugar is going! This helps a lot because it would provide alerts to me and my parents while I am sleeping, exercising and at school. The exercise/school portion of it will allow me to just pop my glucose and get back to work instead of having to walk to the nurse, eat  and miss tons of classwork. Check out this post to learn about nocturnal lows and why they are deadly: Nocturnal lows info.  Dexcom’s website: Dexcom

The fight

The good news is that we have lots of new assets on our side. People from Tandem (the company that makes the pump) are advocating for us. My school nurse who has helped our family out a lot has researched and found lots of new stuff we could use. We have found out that they only took a few things into consideration. We are now going to throw out there how much class time that I miss due to high/low blood sugar. The past few days I have been experiencing blood sugars that are pretty high for me, and I couldn’t do work with it at all. It’s frustrating when the rest of my classmates are sitting there and getting work done on time, and then there’s me; sitting in my desk blankly staring at a wall as I contemplate my very own existence and warp space and time inside my very own head. Our family members and friends are even offering to buy the pump and CGMs for us, out of pocket. We cannot thank these people enough for their support.

tandemtslim
This is the T:slim X2. This is an amazing precision, touchscreen, small pump. This pump is amazing because it can do extremely precise amounts of insulin. Another cool thing is the batteries are rechargeable, it is touchscreen (which is uncommon for an insulin pump), and it updates (exclusive to Tandem pumps). With this pump, you can update it directly via your computer to get better software, new features, and upgrades to old ones. Soon when the FDA approves it, the pump will receive an update to talk to Dexcom. If I start to go high, the Dexcom will tell the pump “bring on the insulin!”, and if I’m low it will tell the pump “STOP THE INSULIN!!!! And big guy wearing us, eat something for crying out loud!!!!”. As you probably already know, with the pump I just punch in the amount of carbs, my blood sugar, and it automatically gives me insulin! And most importantly . . . it comes with lots of cool decals and cases :D. This will not make T1D easier, it just makes it more manageable and less of a hassle to deal with. Tandem’s website: Tandem Diabetes

We will get it

Someday, we will get a pump. No matter what insurance does, no matter what gets in our way. Maybe not today, maybe not tomorrow, maybe not in a month, maybe not 6 months from now. But someday, no matter what it takes, we will get a pump and continue the race of life. Until then, we just gotta put our best attitude forward . . . and kick T1D in it’s ugly behind!!!

kick-butt

 

2 thoughts on “The Fight With Insurance”

  1. Margi's avatar
    Margi February 8, 2018 — 4:13 am

    You are doing an awesome job! Keep fighting!

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  2. Artangel's avatar
    Artangel February 8, 2018 — 11:41 am

    I admire your strength, determination and positive attitude. Keep up the great work and thanks for leading by example!💪

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