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As we wrap up our 2015 Calendar year, one of our big to-do lists is to order as many T1D supplies as we can. Our deductible has been met and as a result, our out-of-pocket expenses are minimal. Minus Continuous Glucose Monitoring (CGM) supplies, we pay nothing.
But yes, we still pay for our CGM - despite the deductible allowance being met.
It's one of the chronic disease biggest burdens we shoulder.
And we are not alone.
(( Shameless plug to write to your US senator to ask our government to recognize CGM use as a medical necessity for Type 1 Diabetes care by supporting bill “The Medicare CGM Access Act of 2014” (S. 2689). )) - CLICK HERE
The cost from CGM is akin to several luxury items or a substantial annual vacation.
Having two daughters that both utilize CGM daily, means that we are using a new sensor roughly every 1-2 weeks. Each sensor is $100.00 and a box of four is roughly $400.00. One box for each daughter means that cost multiplies to $800.00 a month.
The additional expense for using CGM include an annual receiver charge of $500 per child plus a multi-year transmitter cost of another $1000.00 per child.
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| Dexcom CGM |
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| Medtronic CGM |
The reality is to keep both girls on their life-saving, medically necessary, continuous glucose monitors, the usage cost amounts to a whopping $12,600.00.
It's a dilemma for many.
What would you do with almost $13,000.00?
What if the choice was to remain healthy and well, alive?Clearly there is no amount of money that would compete with life-saving technology, especially when it depends on your child's life.
The irony of our predicament is that by using this technology, we have avoided costly in-patient hospital visits, expensive out-patient clinic hours and even additional prescription costs from emergency supplies such as Glucagon. Despite being diagnosed with Type 1 Diabetes, our children are healthy. I am convinced that this is in large part to our steadfast CGM use since 2007.
If you have a moment, use the link above to share your own CGM story. If you have been able to cover the costs or even if you haven't, everyone should have their voices heard. Truly, we can #makehealth.
It's been a long time coming.
Your CGM isn't covered at all? It falls under medical supplies for us and is covered the same of the rest of our supplies. 80/20 until we meet our deductible and out of pocket expenses. I need to add up all the figures but I know they are staggering. Our premimum on insurance alone is 12K plus our Flex spending on at 2500 is meet and from there we have been out of pocket. Haven't been billed yet from the pump we started 3 months ago. It is a crazy expensive journey.. best of luck to you!
ReplyDeleteThank you! It is a crazy ride for sure. To help spotlight CGM, the costs I quoted are based on retail, not out of pocket. Unfortunately, many do have that exact quoted cost and it seems brutally unfair. We hope that we can inspire change so that medically necessary supplies are deemed 'covered' under Medicare/Medicade for everyone that needs them. The lag in bill time is also another issue. While it is nice to have a break in expenses, often, the costs can arrive at once. Very difficult for patients of any chronic illness to manage savings. My heart goes out to those that have been readmitted for things like hydration to prevent/reverse DKA.. the costs can amount to the tens of thousands. Just awful to know that families continually struggle with basics in an effort to stay healthy with T1D. I hope our attempt at urging more of us to speak up, vote, discuss, share and highlight the money spent from families will inspire law makers to act in 2016. Huge hugs!!! We are all together on the same journey and I just know that we will make a difference!! xo Amy
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