They probably won't know at the desk- but they will know exactly who to contact to clarify situation.

This may be true. But before it is, the doctor should have done all of the following:

1. set out in a report the date of diagnosis or diagnoses and the bases upon which the diagnosis was made (which measurements and symptoms over how long a period fulfilled the diagnostic criteria)
2. recommended the procedure you are requesting, and setting out why this is the preferable method of managing the illness, more than any other, by referring to acknolwedged standards of good medical practice, to governmental regulations
3. explain why these rules have a direct application in your specific case (which of the symptoms of the diagnosis are causing you which problems, why these must be dealt with and why applying the rules in Step 3 above will work towards appropriately addressing these issues)
4. set out the disadvantages and concerns (in which ways your condition or the management thereof would be detrimentally compromised and your health potentially worsen) were this treatment modality not chosen
5. found out which doctor (not clerk) in the medical insurance company is responsible for such decisions and address the report directly to that doctor (in German, called "ein Vertrauensarzt" or "eine Vertrauensärztin").

In other words: it's not enough to assume that the medical insurance is completely free to approve or not, nor does it suffice to just accept their decision if the doctor has not yet - fully! - justified the application.

Many doctors simply do not know that they need to spell it all out:

• which symptoms
• of which diagnosis
• are causing which negative health effects in this specific patient
• which measures must be taken and
• what is to be feared if those measures are not taken.

For the medical insurance company, it is always about saving money (and not about your personal well-being or convenience or even health), so it is worth emphasising this latter point: if you don't get proper treatment, your case is likely to cost them more, later on. That point can sometimes open doors.

Good luck!

Mr HH had initially Freestyle Libre and then Dexcom approved, for insulin dependent steroid induced diabetes. This was in 2018/19. Insurer Helsana.

I agree that the doctor should do more. I'm in USZ now and seeing a specialist and they really do the bare minimum most of the times.

I sent 2 emails yesterday to the service which processes the requests, to ask for the reasons of rejections. Still have hopes that they will answer.

And for sure these devices help to manage this complex disease better, so I don't see why insurances aren't really happy to cover the costs.

Thanks! If I don't manage to get the costs covered by 15th of November, I think I will switch to Helsana as well.

Eventually after many months, by calling the call center every 2 days, sending emails to insurance people that refused the cover, and finally having the doctor sending again letters, I got the acceptance of cover.

Funny thing is that the acceptance of the costs will be for ...one year. Even if I wish very much not having diabetes, I don't expect I will be cured in a year. This is a joke to me..

Thanks again to bowlie for sending me sensors in the meantime.

Excellent news! Well done for having been persistent, and thanks for letting us know.... also about bowlie's generosity.

The "just for one year" part is probably not a problem. Many approvals for any kind of medical treatment are for a limited duration, but if they're still needed, later, then a month or two before the expiry of the approved period, the doctor just needs to write a letter stating that the patient still needs the treatment, and needs an extention. That, too, will be granted for a next limited period. And so on.

Yes, it's just annoying all this extra admin effort of myself, the doctor and the insurance people for a health problem that can not be really cured.
While also insurance companies complain for the amount of work that they have and cannot really keep up with

I know this is a bit off-topic, but are these the devices they are considering banning from elite sport during events?

I haven't heard that before Would they also say which is the particular reason for that?

Okay I found something on it:

https://www.bikeradar.com/news/uci-bans-supersapiens/

Personally, I think product supply should be prioritised for those whose health depends on it, not those who want a competitive athletic edge.

There are many hundreds of thousands of T1 diabetics that have no access to these sensors. Not only because of the cost (CHF70 for two weeks CHF1,820 a year) but because Abbott can't be bothered seeking regulatory approval or developing a distribution system. This includes some EU countries where approval isn't actually needed.

if i lived closer i'd come to take them off your hands to reduce this kind of outrageous waste. i saw also that there is one brand of disposible vaping 'cigarette' which people use and then throw away. there's also a lithium battery in that and now those things are littering the streets of the UK.

The problem is Abbott's laziness in not making the battery easily removable. I was literally breaking them open with a hammer to get access. Then the guy at the dechétrie told me to just put them in the battery box, apparently they have a machine that does the work.