Saturday, March 17, 2018

THIS JUST IN: Controlling Your Diabetes = Not Medically Necessary

CONTENT WARNING: Sarcasm ahead along with non-sarcasm. Good luck.

"Dear Member:

The purpose of this letter is to confirm that pre-auth [for your insulin pump with CGM] has been denied for the following reason(s):

Your provider asked us to provide a special type of insulin pump that can also continuously monitor your blood sugar. This was requested to help control your diabetes. This request has been denied as not medically necessary."


Neat! Did you guys know controlling your diabetes isn't medically necessary? Wow, what a relief. All this time I've been worrying about this garbage A1C that I have, but it turns out I shouldn't have to care at all.

Okay, in all seriousness, the letter goes on to explain they cover "these types of insulin pumps" for people with recurrent, life-threatening low blood glucose levels and also poorly-controlled pregnant women.

Maybe they would cover a pump without a CGM and a separate CGM system. I've never had trouble with pre-auth for Dexcom, surprisingly. Buuuutttt they would probably also say I don't need an insulin pump because my diabetes is poorly controlled in the wrong direction (highs instead of lows).

Just remember, kids, in the US of A we have the GREATEST HEALTHCARE SYSTEM IN THE WORLD where NOTHING IS EVER WRONG and PRESIDENT OBAMA RUINED IT FOR ALL OF US. It is sheer, tremendous, tremendous, big perfection.

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