The ins and outs of insurance

A Bedtime Story: Insurance Heartache and Stress.

Knowing what the insurance will pay for and what they won’t and when the insurance covers everything.

My lesson the hard way.

Recently my son’s continous glucose monitor (CGM) stopped working. And my descriptions of stopped working is it would not charge, blink or the OK green light. So of course I went about calling our CGM company for the arduous process of replacing the CGM. After a long conversation we decided (the company rep and myself) that it was truly dead. With this fabulous information the next step was to await the doctors new prescription. Obtaing this elusive prescription seemed far reaching. First I had asked for the company to acquire the needed paperwork form the physician and not the diabetic educator, as we had not visited with her recently. However the company decided to go about this in their own way. They proceeded to contact the educator and she would not fill out the paperwork because she had not seen him. Now The educator we have seen in the past is FABULOUS; simply my son really prefers the male doctor. Because of this we then played a waiting game from November to January. And so the story continues.

While we are in waiting questions such as does a CGM make or break a diabetic day? Really, why not just go old school and just test all day long? But for my son it can make or break his day and week and month. His blood sugars tend to be wildly all over the place causing him to test his sugars more than the 8-10 times a day. Also he has recently started in a running club and driving. So having a CGM that will shut off if he cannot detect a low blood sugar is a life saver, literally. Besides saving his fingers from repeated testing. Moreover, he is able to simply look at his pump prior to sitting behind the steering wheel, at sch images ool, or before running. His CGM can make or break his daily management of his diabetes causing us to miss it horribly.

With the passing of months of mourning we have finally heard from the company!YAY! There is no paperwork form the physician. UGH. The holidays are here! I have called the physician’s office, they already have the paperwork done and faxed back; and we finally have the prescription to the company, creating a no out of pocket payment with our insurance. SIGH–calm and relief set begin to take over. Or so we thought! A few weeks pass. Mind you we are in mid-January, and the company calls me and states they just received the fax from the doctors office. Huh, you mean the one that was faxed in December? (You thought this tirade was complete and our family’s stress was finalized.) This then lead to a 2 hour phone conversation with the company. Me stating and restating that I was informed by the doctors office they had confirmation recite from the fax before the new year began. The representative and manager stated their paperwork demonstrate otherwise. What is a family to do!

The End of the Story

The company did not have the paperwork in hand before the end of the year so it is to be billed on 2016 insurance! UGHHH. Lesson learned (The financial lesson). Don’t wait for the company call and harass everyone until its done right! He has his CGM and all is now going smoothly and with lots of basal rate changes, very few lows and a green light indicating all is well with our CGM.

Moral of the story

Know your insurance and the companies you are working with. you can save money in the end and the ability to maintain a full head of hair at the end! Happy New Insurance Year!

Type 1 Diabetes and Growth Spurts

Growing children seem to eat parents out of house and home. There is never enough food for them! For example, my type 1 13-year-old is eating me out of house and home! And the result is a three-inch growth spurt about every three months. The problem (beyond the obvious sugar control!) is that he wants to eat all day long. Waiting until the next meal might as well be giving him a “death sentence”. The recommendations we received was to eat every two hours. He is able to have an entire meal every two hours. I thought what a great compromise! But he still wants to graze all day long like a cow in pasture! So I try to help him eat good food and sometimes fun foods to encourage eating well.

So why is it a big deal for him to eat constantly? It has to do with insulin, whether via shot or pump. Eating more often requires insulin. Each time he takes insulin he is stacking it on the last dose and essentially giving himself mega doses of insulin, setting himself up for a low. Rapid insulin like Novolog or Humalog have about a 3-4 hour active time in the body. The insulin works quickly but does not leave the body quickly. It basically means we can expect many and frequent lows. Eating every two hours helps with this but does not necessarily eliminate stacking of insulin. But for us it works.

Growing and grazing. Eat, beef up and grow taller. Type 1’s can navigate this easily without negative consequences. Go forth and chow down!

Growing and Grazing

Aside Leave a comment June 24, 2015 Stacey

What is normal?

Type 1 Diabetic and a “Normal” Life

Normal. What is it? Such and easy word to say and toss around. We all have a concept of our “normal.” But can we really define it? Websters online dictionary defines normal as: ” usual or ordinary: not strange, mentally and physically healthy.” Our type 1 children are not the first part. I would not define my child as unusual or strange, and he is well but not always physically healthy. Then in daily life how do we as parents achieve normalcy for our children?

Finding the Norm

The start of finding our normal is not letting diabetes rule our lives, but be an aspect of our lives. Easy…right! Not always. Sick type 1 diabetics tend to not be normal, eating is not normal, exercise is not normal. So we need not to let it be a big deal. Treating diabetes as this is just the way it is and we keep going. Keeping this attitude helps our diabetic children get the norm down as they enter into adulthood.

Practicing the Norm

Get the practice of the norm down. Eating at regular intervals, not snacking all day (which is good for everyone!), having play dates and sleepovers, participating in sports, or anything any other child would do. Years ago a type 1 diabetic was not allowed to do many of these things. But with all of the new technology and medications our children are able to live a regular life. As parents, we need to figure out how to do this and feel safe about it. One way to do this is have a guide-book that helps you as a parent feel safe about leaving your child places with another educated adult. Check our book out for guidance and the many websites and forums for other parenting advice. Now go out and find your norm!