Four things to help with your reimbursement


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1. Letter of Medical Necessity
Your physician will need to provide a letter of medical necessity (LMN) to the Medtronic Reimbursement Assistance Centre (MRAC) on your behalf. This letter is a requirement of all insurance plans which covers continuous glucose monitoring (CGM). An LMN supports your request for reimbursement, by providing your insurance company with a reason as to why you are a candidate for CGM. The LMN might also include continuous glucose monitoring results (if available) - speak to your physician about this.

Download an LMN template for your doctor to complete.

2. Quote You will need to send your insurance company a quote for the device for which you are seeking reimbursement.
Download the REAL-Time transmitter quote PDF to submit with your request for coverage.

3. Device description
It is advisable to send your insurance company a description of the device for which you are seeking reimbursement; this will help them better understand why you are requesting coverage and for what.

Download the CGM product description PDF to submit with your request for coverage.

4. Clinical study support

Supplying your insurance company with clinical study support material can go a long way in helping you communicate your request for CGM reimbursement. By providing clinical support, you can demonstrate the benefits of CGM for your particular diabetes situation.

The following documents may be helpful in working with your insurance company:

  1. Guard Control
    • Click here to download a copy of the Guard Control
  2. Clinical studies
    • Deiss D, Bolinder J, Riveline J-P, Battelino T, Bosi E, Tubiana-Rufi N, Kerr D, Phillip M. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care, Volume 29, Number 12, Page 2730-2732.
    • Bode B, Gross K, Rikalo N, Schwartz S, Wahl T, Page C, Gross T, Mastrototaro J. Alarms Based on Real-Time Sensor Glucose Values Alert Patients to Hypo-and Hyperglycemia: The Guardian Continuous Monitoring System™. Diabetes Tech & Therapeutics 6:105-113, 2004.
    • Garg S, Zisser H, Schwartz S, Bailey T, Kaplan R, Ellis S, Jovanovic L. Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose monitor. Diabetes Care 29(1):44-50, 2006.

    What to do next

    When you have collected all of these documents you will need to mail them to your insurance company. You can usually find the address for your insurance company on the bottom of a pre-printed claim form, or you can ask your employer for the address. It generally takes about 2-3 weeks for your insurance company to review these documents and to send you a response on their coverage decision.