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aeromarv
10-31-2006, 07:53 AM
For those of you eith UHC, where do you all get your pump supplies? i noticed on my EOB for the pump that the supplies are listed as Out of Network when coming from Medtronic. Just wondering if anyone knows of a better supplier when going through UHC.

Cyborg
10-31-2006, 08:22 AM
I use Advanced Medical with UHC. Not perfect, but pretty good.

notme
10-31-2006, 09:38 AM
I had the same issue with UHC and Medtronic. Some of my supplies were covered, the others were not. I use EdgePark. They are more expensive, but in network for me.

kgm0612
11-01-2006, 07:38 AM
I use a company called Focus Pharmacy, located in PA. I get all my testing and pump supplies through them with NO co-pay! They accept the 80% that my United Healthcare plan pays af FULL payment. Give them a call to find out if the plan you have through United is accepted.

Karen

middnite03
11-01-2006, 08:41 AM
I use a company called Focus Pharmacy, located in PA. I get all my testing and pump supplies through them with NO co-pay! They accept the 80% that my United Healthcare plan pays af FULL payment. Give them a call to find out if the plan you have through United is accepted.

Karen

this is a great company.... yes they take the 80 percent as full payment, and do all the leg work for you.

aeromarv
11-01-2006, 10:41 AM
Well, I filled out the forms for Focus today. Will wait and see what they say I guess.

aeromarv
11-02-2006, 05:48 AM
I talked to Focus Pharmacy yesterday. They are apparently out of network for mu UHC plan too! So I'd have to meet a $2000 deductible first!

I guess I'll have to call UHC and find out who exactly IS in network, if anyone!

jeggeman31
11-02-2006, 05:55 AM
I talked to Focus Pharmacy yesterday. They are apparently out of network for mu UHC plan too! So I'd have to meet a $2000 deductible first!

I guess I'll have to call UHC and find out who exactly IS in network, if anyone!


I use Edgepark and Animas. I did attempt Focus Pharmacy and was out of network with UHC also. However I just have a $200 deductible. However I placed my order in Feb and still are fighting with them, and UHC to pay the bill. This last go around UHC said that the stuff is not covered. So I don't know if it is UHC or Focus screwing things up.


Due to that pain in the butt, I returned to Edgepark and will just pay the $200 and then 80/20 for the next $500 Not worth it for me.

notme
11-02-2006, 09:15 AM
Jim, the same thing happened to me. The problem was with UHC for me. They were denying claims for canulas saying it was not a covered item. Then they told me that I had to get these supplies from our mail in pharmacy. When I called Express Scripts they said they had these items and I was required to get them from their Rx plan. When I asked for a price, they could not find the items. They then conceded that I could not get these items from them so they would pay for them. I went for six months ordering my supplies from Edgepark, paying for them (over $900.00) on my credit card and then Express Scripts sent me a check. Finally, they started approving the claims again and this never happened again.....so far.

Poe
11-08-2006, 08:36 AM
Okay, my 2 cents.

I work for UHC and it isn't any better for employees.

I go through Animas for my Durable Medical Goods and pay close to 800 per shipment (5 reservoirs and 5 cannulas) until I hit my deductible. You have to make sure that the supplier is IN-NETWORK to get the most bang for your buck. They will cover OUT-OF-NETWORK but it has a higher copay with a higher out of pocket deductible.

UHC has a contract with MedCo for other medical supplies, insulin, test strips, swabs, etc and they are broken down into 3 tiers. Humulog is a tier 3 drug while Novolog is a tier 1 drug, this novolog is cheaper. All drugs are broken down into tiers. I'm not sure who establishes these tiers, MedCo or UHC (Carrier). That is why many of us had switched from Humulog to Novolog last year. Money talks and it's all about cutting costs.

Once you meet your deductible they are pretty good about covering your costs. Luckily, for me (in a twisted way), I had a incisional hernia just below my rib cage followed by dog bite that hospitalized me for 4 days with staph and strep bacteria. Bottom line, i met my deductible and am on a free ride to the end of the year.