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[IP] Fw: ACA Plans and CGM Coverage



From: Jerry Smith
>To: email @ redacted
>Cc: email @ redacted
>Sent: Sunday, February 02, 2014 9:02 AM
>Subject: ACA Plans and CGM Coverage
>
>
>Hi  Pam,
> 
>The post about your ACA bronze plan was interesting.  So far, CMS has not
issued any ACA regulations about CGM coverage.  However, the same CMS refuses
to move away from local policy articles such as NHIC A33614 which deny CGM
coverage for Medicare recipients because it is precautionary.
> 
>I posted last week about Rep. Carol Shea-Porter (NH, 1st District) who has
proposed HR 3710 (Medicare CGM Coverage Act) which would end this ridiculous
policy.  Do you think that CMS will apply the same reasoning to ACA health
plans?  I was wondering if you have any thoughts about HR 3710 either pro or
con.
> 
>Jerry Smith
> 
>Original message from Pam Brown (Feb. 1):
> 
>Sorry, I can't really help you with any useful info as I have a high
deductible ACA bronze plan so I have to pay all my medical expenses and
prescriptions 100% myself until I reach my deductible/out of pocket max for
the year. After that everything is covered at 100%. With the new pump I'll
meet my deductible soon so sensors for the rest if the year will be paid by
the insurance.
.
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