Wellmark BCBS is a leading insurance provider in the state of Iowa. They also happen to be the only insurance provider in the state that does not cover Continuous Glucose Monitoring systems as a pharmacy benefit.

Why this matters:
Studies show that CGMs users have better overall glucose readings and lower A1Cs. Every diabetic deserves these benefits and deserves access to a CGM without having to make sacrifices in their budget (providing Dexcom supplies for myself will cost over $3000 this year). It is time that Wellmark follows its competitors’ footsteps and no longer treats CGMs as "optional" or "additional" medical supplies.

Because Wellmark BCBS only covers CGMs as a medical benefit, it can be exasperating to figure out how to get supplies filled. Requiring people with diabetes to classify this as a medical benefit, typically designated to cover doctor's visits and surgeries, is nonsensical. 

Difficulty filling supplies:
Most individuals, let alone diabetics, fill all of their prescription medication at their local pharmacy of choice. All Type 1 Diabetics fill at least one prescription at a pharmacy, and many individuals, including myself, fill numerous (a basal insulin, a bolus insulin, needles or syringes, to name a few).  Because pharmacies can't bill medical benefits, Wellmark beneficiaries are required to use third party distributors to get the supplies they depend on. This ultimately results in a choreographed back-and-forth between a patient’s endocrinologist, insurance provider, and the supplier that can be so taxing that the patient decides it isn’t worth it. 

Inconsistency in explanation:
Wellmark claims CGMs are not pharmacy benefits because they are “bulk medical equipment”. They also do not cover any glucose monitors. However, they do cover your testing strips and your needles and syringes. By their own logic, Wellmark should not cover your CGM receiver, but should cover its components (transmitter and sensors), yet no supplies in the CGM suite are covered as a pharmacy benefit). 

Help me in persuading Wellmark BCBS that CGMs and other continuous care items are part of the future of T1D care and should be covered by all insurance companies as a pharmacy benefit without exception.