Ugh, I’m sorry. That stinks. I actually was expecting to need to pay for my Dexcom supplies, but it was like magic–the first time I ordered, there was a bill of $0.00 and it’s been that way ever since. I have Anthem Blue Cross Blue Shield in Indiana. I also pay for the highest premium insurance through my work–which is thankfully still really cheap at around $125/month because I work for a large university and we get great rates (part of the reason I will probably never leave this employer)–so that my deductible is low (I hit it within the first couple months every year). So, I’m not sure if it’s the insurance company itself that considers it preventive or if it’s just considered as preventive and covered under my specific plan. I would assume it’s the insurance company, though. It completely makes sense to be considered preventive since it means reduced hospitalizations that the insurance company would have to pay for due to crazy high or low sugar levels.
Unfortunately, I think your situation with your insurance company is pretty common. I was actually reading a thread in a diabetes advocacy facebook group today about this exact problem. Someone had posted that they’d been denied coverage for an insulin pump (even though they’ve been on one for a long time) because their A1C is below 7.0. Other T1Ds and advocacy groups commented that the same thing happened to them with Dexcom:
“we have seen rejections for CGM renewals for people whose A1Cs are low because insurance companies don’t see them as medically necessary in general. Which is also awful, but we see those much more often than pump rejections.”
“We have a huge local insurance company that monopolizes everything in our state. Their policy on CGM is if your A1C goes down you can get your cgm supplies. If it goes up youre denied. There’s no way to get it back either. If your A1C goes down when you’re denied, you obviously don’t need CGM.”
Obviously insurance policies are set by people with no medical degree or background, which is dangerous. They don’t understand the diseases they are covering… or not covering. Maybe there is some way to appeal your insurance’s decision about it not being considered preventive care?