Confused about supplies

[JJeenn]

I'm trying to find out which supplies are covered by our provincial health coverage to see if I can afford to go on a pump. Anyway, I just called them and the lady told me that the pump itself isn't covered (which I knew), but that infusion kits and insulin pump syringes are. I asked if the syringes were the same as the reservoir, and she said that no, the reservoir isn't covered but the pump syringes were. Huh?? Aren't these the same piece of equipment?? I made sure she wasn't referring to regular insulin syringes, and she said no it said it was specifically for pumps. I looked on the website and, indeed, found these items listed:

Infusion Sets / Kits
Infusion Syringes - 1.8cc and 3cc
Needles / Syringes (Insulin Use Only)

That last one looks like it's referring to pen needles and insulin syringes. But is the second one the same as a pump reservoir? Is it just another name for it? Was the lady just confused? If not then I'M really confused!! Is there something other than the infusion set and reservoir that are needed (other than tape and alcohol swabs and such)??

[June91]

Could it be that although you will be using a pump, a backup supply of pens/syringes and needles should be available as well? I just thought of this because my insurance won't cover pens if I'm already using the pump, but I do buy them for emergencies, etc.

Whatever the case with insurance, I hope you get the pump.

[lelggren]

I believe that the "pump syringes" are the same as reservoirs. Medicare calls them syringes too. But, there is a way, i'm sure, to find out for sure. I hope that you are able to get it taken care of!

How wierd too that they cover pump supplies, but not the actual pump! Hmmmm...........:ridinghor

:wavey:

[JediSkipdogg]

I would recommend calling the pump company of the pump you want to go with and see if they would know about the supplies being covered. They should either have a yes or no answer. And if they say yes on a controversal piece, ask for it in writing or email so if your insurance does deny paying for it, you aren't fully screwed.

[Cyborg]

Some reservoirs, such as the Animas, come with the syringe required to fill them from an insulin vial.

[poodlebone]

I would say the middle item is definitely reservoirs, based on the capacities listed (1.8 and 3.0). I know those are Minimed's two reservoir sizes. I have seen pictures of some reservoirs/cartridges that do look like giant syringes with a needle attached.

[koblenz]

The Cozmo resevour looks like a giant prehistoric syringe with the fill needle attached. It scares my wife a little. :D

[butterflykisses]

I think calling the pump company you're interested in and having them contact your insurance is probably the best way to find out what is covered and what isn't. The pump itself maybe covered differently than the infusion sets and reservoirs. Like a pump might be under durable medical equipment and the sets under medical supplies. The pump companies are familiar with the insurance jargon and can probably sort through it easier than you can.

[Cyborg]

If you leave it up to the insurance company alone, you may find you end up with the short end of the stick.

[JJeenn]

If you leave it up to the insurance company alone, you may find you end up with the short end of the stick.

Yep, I've heard this from more than one person I've talked to. I'm going to contact each of the pump companies tomorrow and see if one of them can make sense of all this for me. I'd also like to see each pump for real before deciding on one, if everything is covered.

[MamaCat]

Ditto to ButterflyKisses! Save yourself a headache and let the pump manufacturers work out the details with the insurance company. After all, they are motivated because they want your business. They are the ones who are going to contract with your insurance company on the price of everything, and they'll be familiar with each insurance company's jargon, too. Who knows? They may even be able to get your insurance to help with the cost of the pump through some loophole in your coverage (hey, sometimes that does happen!). Minimed negotiated with my insurance company for me, and got my out-of-pocket startup expenses down to the $300 -- for the pump and three month's worth of supplies! In any case, you'll still be in control -- if you don't like the final terms, you don't have to commit to the pump.

[JJeenn]

Thank you all for your suggestions!

I called my doctor and he gave me the name of a guy from MiniMed I contacted. He made everything make so much sense! Since I just get provincial health care coverage, and he says they lock him out in terms of being able to contact them, he told me how I can try and convince them to cover a pump, and if that fails I'll go to service clubs. But it turns out that all the main supplies I'll need are covered, so I'm going with the pump (that was the only thing making me hesitate; I'm sure I'll come up with funding from somewhere if the government refuses to cover the pump itself).

Now I just have to decide which one I want ... :s: That's going to be hard, I keep going back and forth. I'm going to get the salespeople out here to show me what each is like before I decide.