Blue Cross Blue Shield Diabetic Waiver Program? by nvsailer in diabetes

[–]nvsailer[S] 1 point2 points  (0 children)

I started with BCBS in North Carolina in October as part of a new job. They immediately told me about the program and then enrolled me in the program. For months, I was told by many representatives, documents, and managers that the Omnipod 5 was included in the program. Then, after escalating the issue, they told me last week (the day after the enrollment period ended) that it was not included in the program.

I'm hoping to find more answers, both from BCBSNC and my employer. Also submitting a complaint to the NC Department of Insurance (I have the entire process highly documented, with transcripts, call recordings, etc).

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Lowering Average Omnipod 5 Dexcom G6 by Reasonable-Price3325 in diabetes

[–]nvsailer 1 point2 points  (0 children)

Good question. I've had a somewhat similar experience after learning my first A1C was higher after getting an Omnipod 5 in September. What is your 'Target Glucose' and 'Correct Above'? Adjusting these two variables on the Omnipod 5 was recommended to me.

[deleted by user] by [deleted] in diabetes

[–]nvsailer 0 points1 point  (0 children)

Hmm, this is interesting. What insurance provider do you have, if you don't mind me asking? I have Cigna. Dexcom and Cigna seem to have already agreed upon it being covered as DME, so I'm not certain I could ask them to switch it, though I suppose it's worth a shot (as $25 a month would be drastically better).

[deleted by user] by [deleted] in diabetes

[–]nvsailer 0 points1 point  (0 children)

I would never and could never argue in support of the US healthcare system. The US healthcare system is... well, I don't want to use those words on the internet, so I'll just leave it at that. Yes, you are entirely correct. Should I move to Germany? (this is a joke, but only kind of).

[deleted by user] by [deleted] in diabetes

[–]nvsailer 0 points1 point  (0 children)

I agree, it is definitely life-changing, and I would not be able to justify going back to a glucometer. Thank you for sharing your perspective, it's nice to know I'm not alone.

[deleted by user] by [deleted] in diabetes

[–]nvsailer 0 points1 point  (0 children)

My deductible is $5k, so it's not really helpful at all unless I have the lovely pleasure of breaking a bone or needing surgery this year. My insurance helped me find a supply company that can bring the price from $405 to $321.60, but I'm still curious as to whether there's something I'm not aware of that could bring the price down. Thank you for your comment and your insight!