FUDiabetes

Sensor and Fraud Discussion

I split the thread that we hijacked and put the discussion over here.

That is quite unfortunate news. While we didn’t have much luck with resetting sensors once we got on the G6, if it was working for you and you were able to reset a transmitter that is a good amount of savings.

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The 8G Firefly has already been passed over by the 8H

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And I know of one person who restarted the first 8H sensor he tried… so at least there’s that?

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I’m not interested in restarting sensors. I’ve never seen the point of it. I replace mine every 10 days like I’m supposed to. Why people need to find ways to hack this stuff baffles me. I’m not special, if I can follow the rules, everyone can too. These restarts and hoarding supplies is why insurance doesn’t want to pay for this stuff and make it a pain in the ass to place orders. It’s insurance fraud at the very least.

Well, restarts are helpful to me. I also follow rules, also don’t think I’m an exception, and also don’t want to cause problems, but I have no qualms restarting sensors. They are very expensive and don’t always last what they’re supposed to last, so I see squeezing a few extra days out of one as a kind of balance.

I consider myself one of the more fortunate ones when it comes to my ability to get my supplies, but I definitely have a budget I need to honor as well. These hacks are how some are able to get their supplies at all. I guess we just come from different viewpoints is all.

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I have a huge problem with all of these Medicare Dexcom patients bragging on forums about how they have accumulated 12 months of sensors through restarts. Tax dollars are being spent on supplies that don’t need to be bought in the first place. A complete waste of money. Fraud is fraud no matter how you sugar-coat it.

I’m not in a position to comment on that as I don’t rely on Medicare myself. I do have a friend who uses Medicare and has to pay hefty amounts for his sensors. He follows the rules, and he struggles to get his supplies. Can’t lie… if I had to pay outright for these things, I could definitely see the temptation.

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I’m not on Medicare either and pay zero for Dexcom and Tandem supplies. The trend that is happening right now is alarming and should be stopped.

Paying zero for your supplies sounds awesome. I just called to refill my 3 month dexcom order and was quoted $541… and I met my out of pocket in August. I can see how you’d be alarmed since zero is a pretty sweet deal. Hopefully you can see how restarting is a necessary part of my continuing to be able to afford my supplies. We both want to be able to afford the tools we need in order to manage this disease.

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Do you throw out your lancets after one use too?

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Nope. Replace them once a year. Your example is way off from restarting the same sensor for a month and keep reordering 4-5 sensors every month afterwards.

A whole year! You must have very soft and supple fingers!

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We will restart sensors if it is giving good data. Reason being that all sensors are not good. So if this sensor is good then roll with it while it lasts. We do not always get to 10 day on our G6 sensors so can not always restart and if we can get a restart then we are unlikely to get past 12~14 days total on the one physical G6 sensor.

Dexcom will replace any G6 sensor which has failed before a full 10 days are up.

I am more interested in getting 30 days out of a box of three G6 sensors. So if I lose a few days on one sensor and gain a few days on another sensor then I figure it all works out for the box and do not call for replacements for the sensor(s) which did not make the full 10 days. However if we are not getting 30 days from a box then I will call for replacement sensors. Usually one more sensor is enough to let us hit the 30-days for the box unless we are having really bad luck.

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Just lazy. Still use the same spot in the middle of my thumb that I’ve used for 37 years. No callus and still on the 3 setting on my finger poker thing.

I think no matter what the system, there are people who abuse and people who don’t. Unfortunately, do to their own bragging or via spotlight from others, we more often hear about those that abuse.

I think there are a significant number of people out there who do restarts for the same reason some people ration insulin - they can’t afford it.

It seems with any system, the difficulty is always finding a balance where the majority of people using the system get what they need. Unfortunately, the middle ground always allows for some to abuse it, and others to get less than they really need.

On terms of cost, I can say that I restart sensors. However, I don’t have a stockpile. I have the philosophy that if “it isn’t broke, don’t fix it.” Restarting a sensor saves me money and the insurance company money. As a matter of fact, when I switched from the guardian to the dexcom, even after the dexcom stuff arrived, I finished out my medtronic supplies.

I think it’s important to add that logic is almost never a part of the insurance claims process. It is a tough fight to get insurance to comprehend why I used 3 sensors one month and only 2 the next. It was a fight I made time for, but I also understand a fight not everyone is willing or able to make. I can see why some folks, therefore, choose to get 3 sensors per month, even if they have sensors left.

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Right, I don’t see why this would constitute fraud.

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The fraud would be telling Dexcom you have zero sensors left and need to order more when you’re sitting on a pile of them.

It is only fraud if you sell them.

Do you run your insulin vial down to the last unit before getting more?

Is your insulin script for the exact number of units you use every day, or do you have a cushion built into it?

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How would this save yourself and your insurance company money? Or does Dexcom hand out all these things for free?

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It’s fraud. Sugar coat it anyway you want. If your insurance found out you’re sitting on a stockpile of supplies, they’d cut you off. I don’t know what’s so hard to understand about this.