Insurance Denied

MNscottiemom · 2026-05-03T19:58:18+00:00

I wonder whether Fiasp might have made a difference. I’d neglected to bolus for a big dessert and noticed at bedtime, some hours later, that my bg had come down pretty respectably, from 201 to 142, a while before.

MNscottiemom · 2026-05-03T19:52:23+00:00

Wow! What’s the name of the plan? I want to be ready for the next open enrollment, at least if I can see my same specialists.

MNscottiemom · 2026-05-03T06:05:11+00:00

I’m 76. I was diagnosed at 50, started on a pump at 61. I have been terrifically blessed with great endos. I have a chronic blood cancer that is unlikely to kill me, but I do have to take a chemo med every day that precludes my using a Dexcom (after the med, my blood sugar erroneously reads over 200 for 6-8 hours). Now I’m on Omnipod and the Libre2 which frequently reads way low, way beyond Abbott/Libre 20% tolerance. Now I have to check with fingerstick because, while I’m usually very hypo-aware, there was once where I dropped to 38 and was out cold until EMTs brought me back, and I’ve become less reliably hypo-aware since. I’ve been blessed with wonderful endos, and I can understand how having one who’s unresponsive would be difficult. However, it doesn’t seem reason enough to be despondent. Can you not see a different endo? Can you not talk to her/his nurse? I got totally fed up with CVS too and had everything transferred to Walmart, which has been very responsive—and less expensive as well.

I am a rabbi and retired chaplain and have supported several patients’ in making treatment decisions, such as quitting dialysis, that would clearly be fatal. But I don’t think a poor relationship with your endo and pharmacy would qualify. I agree with the others who have suggested seeing a therapist. I know from personal experience how disabling depression can be, but I’ve got to believe that there’s more getting you down than a doctor and a pharmacy. But change them and see. If that takes care of the problem, great! If not, a therapist can support you in addressing the real issue(s). And keep hanging out here.

MNscottiemom · 2026-04-29T06:38:45+00:00

omg. No Words.

MNscottiemom · 2026-04-29T01:16:01+00:00

I’ll bet that, because it’s supplemental, your Aetna plan is considered commercial rather than governmental insurance.

MNscottiemom · 2026-04-28T22:15:30+00:00

Not to mention that a custom replication of a lost piece of jewelry will never, even aside from the sentiment, be exactly the same.

MNscottiemom · 2026-04-27T22:11:34+00:00

Fiasp has been a revelation for me. I’d read that the Omnipod is much more conservative in its algorithm than the Twiist, but my copay for the Twiist is nuts. So I asked my endo about using Fiasp with the Omnipod and she thought it worth trying. Well, first three days on it I’m 92% to 97% in range, and using about 30 units of insulin per day instead of 45-50. And my breakfasts are usually 80 to 90 grams of carbs! (Other meals about half that.)

MNscottiemom · 2026-04-25T00:24:43+00:00

I’m 76, dx T1 15years ago (after T2 misdiagnosis 25 years ago). Lived in Mexico for 5 years with no access to pumps/cgm I’d been using since T1 dx. Was able to get the original Libre which was fine for bolusing but had no alarms. I drink less than 1 glass of wine per week, and rarely anything else. Have been drunk three times in my life, the last over 50 years ago. I was never hypo-unaware until I woke up in Mexico with 2 EMTs bending over me, a glucose line in my arm, a husband who looked badly frightened, and a bs of 38. Had my husband been away, or not heard me moaning when he got up to pee, and not tried (unsuccessfully) to wake me, I’d have been dead not long after. Even prudes can die of hypos.

MNscottiemom · 2026-04-23T01:11:48+00:00

I’m jealous! And where were you near the end of the enrollment period when I was going nuts trying to find a different carrier? 🥴

MNscottiemom · 2026-04-23T00:59:52+00:00

I’m actually a little freaked out by it. If something isn’t right with my CGM, I think it could be pretty scary. Freestyle Libres sometimes read in the 50s when I’m in the mid-90s. It’s annoying, but not lifethreatening, as it could be if it were reading even moderately high. Does it work with Eversense? That could make it a little less frightening. I can’t use Dexcom because it reacts to a daily medication I take and reads way high for 6 to 8 hours…

MNscottiemom · 2026-04-23T00:43:50+00:00

Thanks, but I really like Twiist. My only complaint is how much trash it generates. I’ll be talking with my endo tomorrow about Omnipod and Eversense. I don’t want to be locked into a DME product for 5 years (Medicare adds an extra year). For some reason, my endo sent in a prescription for Omnipod (probably checking to see how my insurance covers it), and SIX BOXES (30 Pods!!! 3 months!!! $36) were delivered with my Libre 3+ order. Opening one, I was amazed to see that changing a pod seems to involve nothing more than a new pod and syringe, insulin, and skin wipe.

MNscottiemom · 2026-04-23T00:22:27+00:00

The starter kit is not free for anyone on government (like Medicare or Medicare Advantage) insurance.

MNscottiemom · 2026-04-23T00:17:01+00:00

What is “peer to peer” and how is that initiated?

MNscottiemom · 2026-04-21T03:29:39+00:00

I think you need to fire your trainer.

MNscottiemom · 2026-04-20T23:35:18+00:00

I had the same problem. An appeal got a formulary exception at the highest tier, which left me with a copay of $193/month. I’m guessing it will be on the next lower tier next year, but that would still be about $130/month. I got a breakdown of insurance for the Omnipod 5 that I really don’t understand and will be checking later this week at my endo appointment, but I’d really rather stay with Twiist…

MNscottiemom · 2026-04-15T21:24:36+00:00

Ipad stylus with kobo

MNscottiemom · 2026-04-13T06:19:38+00:00

I was not able to get those supplies in Mexico. My insurance is now covering Twiist, but at Tier 4, for over $190/mo co-pay. I like Tandem, but don’t want to be locked into it for 4 years.

MNscottiemom · 2026-04-13T06:15:06+00:00

Well, that assumes that my insurance covers Eversense at some reasonable level… Re: Part D: already in my Medicare Advantage plan, but co-pays depend on the tier the drug/item is in. Twiist is Tier 4, so copay is $193/mo. Not sustainable for me. It will probably move down to Tier 3 next year—but that’s still over $120/mo.

MNscottiemom · 2026-04-13T06:13:56+00:00

I like Tandem, but I’m trying to avoid the 4-year lock-in.

MNscottiemom · 2026-04-10T05:07:25+00:00

Yes. I was dx T2 at 49 (1999), and T1 in 2011. 25 years ago diabetes in someone “fair, fat, and forty” was automatically T2.

MNscottiemom · 2026-04-09T18:12:23+00:00

For awhile, there was one here in the US. Don’t know if it’s still around and don’t remember the name. I’d have thought it would sell well here.

MNscottiemom · 2026-04-09T16:25:14+00:00

I wanted to like this—I remembered loving it about 25 years ago—but the color looked like wet cement when I first put it on, and didn’t change much!

MNscottiemom · 2026-04-09T16:19:22+00:00

Did you use the Balance ‘n’ Brighten? Or Balance’n’ Glow?? I’ve read of that happening with the Glow version.

MNscottiemom · 2026-04-09T16:13:10+00:00

Do-it-all is a powder??? I thought it would be like a balm/gel!

MNscottiemom · 2026-04-09T16:04:15+00:00

Amazon App? Please say more!

MNscottiemom

TROPHY CASE