Effective June 1, 2009 BC/BS Massachusetts has changed their CGMS policy. It is a policy change. It is NOT plan dependent.
They will cover (with doctor's recommendation) CGMS's without contortions for diabetics. It is no longer dependent on the things like 1) seizures 2) passing out 3) ER visits 4) gastroparesis, etc. They are covered period.
However, they are covered under durable medical equipment which tend to have a limit on them. My old group PPO which is considered to be the cream of the crop and that I was paying $445 a month for had a $750 annual maximum - obviously not enough to pay for a CGMS or a pump.
The choices that I debated this time (as direct pay) were PPO/$1,000 deductible - $1,500 annual durable medical equipment max and the one I chose HMO Blue/$500 deductible - $750 annual durable medical equipment max.
So the good news is they changed the policy; the bad news is coverage is nominal at best.
For those who have had their CGMS and pumps paid for/reimbursed, what category were they on your insurance plans? What amount for the initial equipment? What amount thereafter?