Michael Edwards - Humana Medicare Advantage customer.
Starting in early August 2023 Humana was contacted regarding coverage of a CGM. I have transcripts where coverage information varied between 80% (as DME) covered to 100% (Diabetic supplies). Directed to Edwards health care and after back and forth - and being told that since Michael is not on insulin, no coverage. Called Humana and spoke to an agent. I was told that YES it will be covered (probably 80/20). Directed to call CSS pharmacy. Started that conversation with facts including that Michael is NOT on insulin. Told that wasn't a problem. That was in September. I continued to check in with CSS. The most recent check in was 11/29/23. I was told first that an authorization was needed from the doctor. Got information from doctor's office that the form WAS sent over on 11/14. Called back to CSS. Then told NO coverage due to Michael NOT being on insulin. Then I call Humana again. Directed finally to Jeff who was helpful and stayed on the line during calls to CSS and then Centerwell Pharmacy. He did not stay on the line after connection to Centerwell. I feel that Humana really impeded my search for coverage. I will now order the FreeStyle Libre 2 through Amazon Prime. I have been paying $86 every 14 days since early August. At least through Amazon Prime I can save about $44 a month. FYI A1C was 11.4 (dangerously high) but first A1C after 3 months with the CGM the A1C was 8.2 - an amazing drop. Even without insurance coverage that is a compelling reason to continue using a CGM. Humana dropped the ball on this issue?
Desired outcome: Coverage of CGM - even if a small amount. An apology of what I was put through, the waste of my time. Education so that agents don't give out false information.