Cheryl’s Story

I use Dexcom G6 constant glucose monitor for controlling post pancreatectomy diabetes (I have half a pancreas). Getting sensor and transmitter refills for the G6 system is challenged each time by the supplier, Medicare and my secondary insurance. If I use the DME supplier, they request prior authorization, and sometimes refuse to send supplies out of schedule when I need them before traveling overseas. They shave the timing so close that often supplies are delivered late. If I pay cash out-of-pocket to get supplies more timely from the pharmacy it may take about 3 months to get $1,258 reimbursement and 2 to 3 hours of phone calls and emails with the pharmacy, Medicare, and [my health insurance] to get 3-months’ supply of sensors. [Prior authorization] is an unnerving, time-consuming process to be endured for the sake of keeping my diabetes in control and not becoming an even greater burden to the insurance companies as a result of secondary complications that result when the disease is not controlled. This does not make sense.