Insurance Approved Me for Continuous Glucose Monitor and Insulin Pump

Victory - Insurance Approved Use of CGM

Insurance Approving Me for CGM = Victory! and nobody says it better than Entourage's Johnny Drama.

Shortly before noon I received a call from Allison, an inside rep for Medtronic.  She phoned to go over the pricing of both the MiniMed Paradigm REAL-Time Revel Insulin Pump and the Guardian REAL-Time Continuous Glucose Monitoring System.  The Revel is a combined insulin pump/CGM and the Guardian is a standalone Continuous Glucose Monitor.  The purpose of her call was to also inform me that my insurance had approved me for these devices.  It is now up to me to choose which one I want to try.  My wife, who was sitting next to me, had an overwhelming sense of relief on her face, on the verge of succumbing to tears of exultation.  It’s been a long couple days since Saturday morning’s severe hypoglycemic episode and subsequent ambulance ride to the ER.  The insurance approving me for the continuous glucose monitor is a big step, especially given that the doctor seemed unsure if they would.

How much will the continuous glucose monitor cost me?  Everyone’s insurance is different so please don’t use these numbers as any indication what a CGM might cost you.  Also keep in mind that these types of devices usually drop in price over time.  After meeting my deductible, the total cost for the Medtronic Guardian CGM device is approximately $598, plus a recurring $263 every 3 months for the sensors.  If I choose to go with the Medtronic Revel device that acts as both a pump and CGM, the initial cost of the device will be around $940, plus a recurring $144 every 3 months for the sensors and infusion sets.  So, surprisingly (or not so surprisingly), the unit that combines the insulin pump + CGM is actually cheaper in the long run than the stand alone CGM, nearly $120 cheaper every 3 months.

I also have to remember that if I choose to go with the Revel (CGM + insulin pump), my current pharmacy co-pay costs for my Lantus Insulin, Novolog Insulin and Novofine disposable pen needle heads will no longer exist, since my sole insulin source will be from the pump.   However, I’m not going to let cost make my decision.  In the long run, I have to be comfortable with using the pump.  I hadn’t really considered it until recently.  Hopefully, Monday’s doctor appointment and device demo will ease some of my concerns.

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