Yesterday was an eventful day for me, but not in a good way. Started at the breakfast table with a call from ExpressScripts (recall my military-provided pharmacy) stating that they needed to talk to my GP about two related items concerning my recent request for the Libre 3 CGM to help with my diabetic control. First, they had to confirm that no drug interaction was present. How a device that measures glucose interacts with medication is beyond my Ph.D. understanding. Second, they wanted to confirm insurance coverage. Get this: ES, which administers the military’s pharmacy program, wanted to know if the government’s pharmacy program (Tricare for Life) covered CGMs. This also escapes any logic known to humans.
So I called my GP and explained the situation to them, and they assured me they would contact ES and resolve the problem. I left home and traveled about an hour north to where our son is building an ICF (Integrated Concrete Form) home to help him install temporary electrical service in the basement/ground floor of the building where they will live until the upper stories are completed. We went to Mineral Wells, TX, for a TexMex lunch, during which I received another RoboCall from ES. This time ES stated that they had not received any contact from my GP, and if they did not hear back by the end of the business day, they would unilaterally cancel the CGM script.
I went back to calling my GP’s office, where luckily, I got hold of the nurse who had been handling my requests previously. We reviewed all past conversations with her office, by now at least five, and again she assured me she would contact ES and resolve the matter and get back to me.
Get back to me she did with the news that the ES insurance would not cover CGMs for me. So here I am, a 100%+++ retired USN Naval Officer who served at the pleasure of the President of the United States and, while doing was subjected to Agent Orange and, as a result, is on Dialysis. They denied coverage for a CGM to aid in the exact diabetes that they, the US Government, were directly instrumental in subjected me to conditions where the probability of becoming diabetic was greatly exacerbated.
The “logic” of all of this escapes me. I’ll cool my jets and see what is under the next rock. Meanwhile, my GP will contact CVS to ascertain if they will accept Tricare coverage for CGMs for me. Stay tuned. I’m certain the saga will continue.