So I’m trying to get a CGM (continuous glucose monitor) covered that is in fact on the formulary for United Healthcare and they keep rejecting it claiming that it isn’t. No matter how many times I call them and try to explain this to them and that I have previously been able to get it covered under pharmacy, they give the same precanned answer that it is actually DME (durable medical equipment) and they are rejecting my claim. Would this be a situation where I should escalate this to the State insurance commissioner as it seems to me that at the very least they are releasing an inaccurate formulary and aren’t being the least bit helpful? Has anyone tried this before and had any luck?
submitted by /u/lgbwthrowaway44
[link] [comments]
So I’m trying to get a CGM (continuous glucose monitor) covered that is in fact on the formulary for United Healthcare and they keep rejecting it claiming that it isn’t. No matter how many times I call them and try to explain this to them and that I have previously been able to get it covered under pharmacy, they give the same precanned answer that it is actually DME (durable medical equipment) and they are rejecting my claim. Would this be a situation where I should escalate this to the State insurance commissioner as it seems to me that at the very least they are releasing an inaccurate formulary and aren’t being the least bit helpful? Has anyone tried this before and had any luck?
submitted by /u/lgbwthrowaway44 [link] [comments]Read Morer/HealthInsurance