Diabetes Forums » Staying Healthy » Pumping Insulin » Insurance Problems


Welcome to Diabetes Forums!

You are currently viewing our boards as a guest which gives you limited access to view most discussions and access our other features. By joining our free community you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content and access many other special features.

Registration is fast, simple and absolutely free so please, join our community today!

If you have any problems with the registration process or your account login, please contact contact us.


Reply
Insurance Problems LinkBack Thread Tools Display Modes
  #1 (permalink)  
Old 10-18-2006, 06:40 AM
Junior Member
 
Join Date: Oct 2006
Posts: 2
Insurance Problems

[font="Comic Sans MS"][/FONT
Has any ever had problems with your insurance coverance for pump supplies? I get my insurance from work and as everyone who wears a pump know we need our supplies. They have not been covering some of my supplies. I have a PPO insurance and I don't understand why and I am sick of fighting. Does anyone have any suggestions? Please Help.

Martina D
Reply With Quote
  #2 (permalink)  
Old 10-18-2006, 07:08 AM
JediSkipdogg's Avatar
Senior Member
I am a: Type 1
 
Join Date: Sep 2005
Location: Cincinnati, OH
Posts: 8,356
Are they not covering a complete order or part of that order? There are multiple reasons but it depends on the situation....

1) Your insurance may only cover 80% and you are getting bills for the other 20%.

2) Your insurance may not cover certain supplies. I once was on an insurance that wouldn't cover the batteries, alcohol wipes, etc. They covered the tubing and cartridges ONLY.

3) You may be ordering more than your insurance allows. I know at one point I was on a 2 changes per day system. That means 5 boxes in 3 months. Well, on one insurance I was only authorized 4 boxes, so my doctor had to write a letter to Animas to send to the insurance company to cover that extra box.

4) You may have reached your max insurance coverage. This is very very rare, but some have max limits in certain areas. I know one member on here that has $1500 on max durable medical equipment a year. Well, pump supplies fall under that and $1500 is only about 6 months worth. So the rest is out of pocket.

Those are the top 3 reasons I know they wouldn't cover supplies unless you are ordering from somewhere else and not from the pump makers (some order supplies from 3rd party suppliers.) So can you elaborate a little more on what they aren't paying for?
__________________
●Blue Ash, Ohio Police Dispatcher
●Type 1 diabetic for 25 years (11 months old)
●Animas pumper since December of 2002
~IR 1000 (Dec. 2002-Jan. 2005)
~IR 1200 (Jan. 2005 - ?)
●LifeScan OneTouch UltraSmart

Diabetes is an Art, NOT a Science. You must master the control by skills and not by knowledge alone.
Reply With Quote
  #3 (permalink)  
Old 10-18-2006, 08:37 PM
Cyborg's Avatar
Senior Member
I am a: Type 1.5
 
Join Date: Feb 2006
Location: Orlando, FL
Posts: 7,846
Ok, one more time...

I suggest you get your "Certificate of Coverage, Riders, Amendments, and Notices" for your policy and read it yourself. Good luck.
Reply With Quote

Reply


Thread Tools
Display Modes
Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On


» Log in
User Name:

Password:

Not a member yet?
Register Now!

All times are GMT -7. The time now is 03:06 PM.

For Advertising:

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32