One Prescription Gone. Just Not the One I Expected

Managing Diabetes involves making several decisions each day, like what to eat and what not to eat. It also involves two or three doctor’s visits per year as well as the occasional visit to the pharmacy. One thing I did not count on is the fact that managing diabetes sometimes involves having to deal with rejection letters from health insurance providers, especially when the day job changes insurance companies. That happened to me this year and it resulted in a denial of one of my prescriptions. Since my goal is to get rid of all my prescriptions, I am fine with dropping one. I just wish it wasn’t the prescription for my constant glucose monitor (CGM): the most useful tool I had for making the changes I need to get back to “normal”.

To be honest, I should have seen it coming. When I was first diagnosed, the insurance company that we were paying at that time did not want to cover a CGM, sending me a denial letter in which they basically accused me of not taking my diagnoses seriously. I think they based that on the fact that I did not do things their way: going to a dietitian, signing up for their special monitoring program, etc. As I wrote in “Continuous Glucose Monitors Are Game Changers,” I am a researcher and I chose to find my own answers when it came to diet, exercise and other ways of managing diabetes. It seems as if the insurance company did not like that. Eventually, there would be a change in policy, and the insurance company began paying for the Dexcom G7 but it took two different appeals to get to that point.

As I wrote in the post mentioned earlier, having a CGM is a game changer for diabetics and should be a standard part of the health regimen for those dealing with the disease. I learned quite a bit while using the device and was able to make several big adjustments based on what I was seeing. During the second half of 2024, I was able to keep my readings in a very tight range resulting in an A1c that is trending in the right direction: remaining below 7 and hopefully at my next official reading it will be below 6.5. But what would life be without times of change and last year ended with a change in insurance carriers mentioned earlier.

I appreciate the fact that my day job offers one of the better insurance packages in the area and that they do their best to keep my out-of-pocket expenses from rising. To maintain that level of service at the right price, the company changed insurance providers at the start of this year. When they announced the change, I should have thought about the trouble I had with our previous provider in getting the CGM prescription approved. When it came time to renew the prescription this time around, I received a new denial letter describing the new company’s policy of only approving constant glucose monitors for people who are on insulin. I think this policy is a bit shortsighted as it overlooks the fact that a CGM could help keep me off insulin. My new insurance company would rather pay for treatment instead of paying for prevention.

So, I have lost what is a great tool for managing diabetes but while I am disappointed, I am not defeated. I believe that God is in control, and everything happens in His timing. God opened the door for me to get a prescription for the Dexcom G7 and this year He has closed that door and told me to move on. I have learned what I needed from wearing a CGM and God has said it is time to start getting off of my prescriptions. The first of them is done and gone. Now, in Christ, I work to get off them all.