Breakthrough T1D insurance and appeals guide
Practical guidance on prior authorisation, denials, and appeals for insulin, continuous glucose monitors, pumps, and test strips.
Best for
Anyone whose insurer has denied a CGM, a pump, or a quantity of test strips.
Why Kave includes this
Denials for diabetes technology are routine and are overturned on appeal far more often than people expect — but only if someone writes the appeal. This guide tells you what to say and what evidence to attach, which is the difference between a denial that sticks and one that does not.
- Expected cost
- Free. Guidance and templates carry no charge.
- Insurance requirement
- For people with insurance who are facing a denial or authorisation hurdle.
- Who qualifies
- Anyone with type 1 diabetes and their families.
- Where it is available
- Nationwide (United States)
- How you use it
- Online or by phone
- Languages
- English and Spanish
Limitations Kave wants you to know about
- Guidance, not representation — nobody files the appeal for you.
- Oriented to type 1 diabetes, though much of it applies to type 2 technology denials.
- Plan rules differ; your own plan documents are the authority.
Verification
Compiled by Kave on July 1, 2026 and link-checked. Not yet independently verified. Kave assembled this from the organisation’s own published material and confirmed the links resolve. No reviewer has confirmed the eligibility details against the source, so check them on the official site before you rely on them.
- Compiled
- July 1, 2026 (28 days ago)
- Next scheduled review
- September 29, 2026
- Reviewed by
- Not yet reviewed
Sources used
- Breakthrough T1D — read July 1, 2026
Kave quality score
86/100
Kave lists resources scoring 80 or above that also clear all four mandatory gates.
- Patient impact21/25
- Affordability or financial value19.2/20
- Transparency13.2/15
- Accessibility12/15
- Ease of use7.6/10
- Geographic reach4.7/5
- Institutional credibility4.5/5
- Privacy and data practices4.2/5
Geographic reach is deliberately worth only five points, so a strong local resource is not pushed out by a weak national one. Read the methodology.