How?!?!?!?

DCaplinger · #1 (**permalink**) 06-09-2008, 05:25 PM

Okay, y'all, I go for my next A1c blood draw this Friday. Two weeks later, I have my next Endo visit. I have talked to the doc before about going on the pump, and I think he'll okay it. I spoke with the MiniMed rep today, and found out what my copay will be for it... $1800+. I simply can't afford it. What with the price of gas, and my wife being out of work... I just don't get it... How did you all afford to get on the pump?

Regards,

xMenace · #2 (**permalink**) 06-09-2008, 05:30 PM

DW and I both have plans. 100% covered.

Keezheekoni · #3 (**permalink**) 06-09-2008, 05:30 PM

The MiniMed rep should have told you about their no-interest financing. I think anyone who has a copay of more than 20% has used that.

Some of us have lucked out and have already met our max out-of-pocket costs for the year, and we're able to get them free that way.

notme · #4 (**permalink**) 06-09-2008, 05:31 PM

All of our plans are different Darian. For me, there was a maximum on my out of pocket expenses. I had met all but about $200.00 so I got my pump at the end of the year. There is a chance you could pay that off in payments Darian if you could afford it, but you need to check and make sure the supplies are covered monthly.

solox316 · #5 (**permalink**) 06-09-2008, 05:32 PM

That is frustrating to hear, I am sorry. Our economy is having a huge trickle down effect in many areas. Sorry I can't help, I am fortunate to have had mine covered in its entirety. Hopefully some one else can offer some more helpful advice.

It looks like, by your sig, that you have made fantastic improvements thus far though! I wish you the best of luck

Gordonm · #6 (**permalink**) 06-09-2008, 05:51 PM

My insurance covers 80% of pump and supplies. It cost me around 1200 for startup on the pump. Not cheap by any means. I just bit the bullit and went for it. As I look back on it I would probably pay double what I paid. It has been well worth it for me. I envy all of you that are covered 100%. Our insurance used to be that good but no longer.

mcgriff · #7 (**permalink**) 06-09-2008, 06:56 PM

This is how I was told the transaction works with the Cozmo. Once they have your info your doctor sends the script to Smiths. Smiths then sends the pump to you and a bill follows. You contact their finance department and set up a payment plan or pay it off right away. With the Cozmo you get 12 months without interest to pay it off. I asked if it was similar to a line of credit and the nice lady said no, it's like any other medical bill. This is only what I've been told and it is not from my firsthand experience. I'd get the pump and work out the cost later as it could potentially add years to your life.

JediSkipdogg · #8 (**permalink**) 06-09-2008, 07:17 PM

I've heard if you pay it off in full then you get a discount. Whereas if you pay it on a monthly plan you just pay the full percent part of your copay.

My first pump my parents paid for the copay and my most recent pump I had a $500 out of pocket max for that insurance plan and trading in my old pump I was given a $750 credit. I'm not sure what I'll do when my current pump's warranty is up in January. I'd like to actually keep my current pump as a backup so I may have to bite the bullet and do a payment plan. It is tough especially with increases in everything else for daily living.

BlueSky · #9 (**permalink**) 06-09-2008, 07:18 PM

Ask them to give you a pump on loan for a month or two. Then you can decide whether it is worth the cost. Either way, you will learn a lot from the experience.

I did this, as I would have had to pay the full $6,000 price. The Cozmo rep offered to give me as much time as I needed to pay it off, which was a fantastic offer. But I decided that it still wasn't worth it, so I gave it back. Using the pump for a month was nevertheless very worthwhile. It enabled me to work out my basal requirement profile, and it gave me useful insights into making better use of MDI.

poodlebone · #10 (**permalink**) 06-09-2008, 08:51 PM

I am very fortunate with my insurance. Pumps and the consumable supplies are covered as DME 100% so my costs for pumping are $0. Actually, I do have a $10 co-pay for insulin because it's a prescription. I also have a $10 co-pay for strips. My insurance also just paid for an upgraded pump and CGMS kit, which I haven't been trained to use yet and am impatiently waiting for MM to call.

kgm0612 · #11 (**permalink**) 06-10-2008, 06:53 AM

Darien.........what insurance do you have? I get my pump supplies & test strips through a mail order pharmacy that accepts what my insurance pays as full payment. They also do this on pumps.

Let me know and then I'll PM you with the info.

Karen

DCaplinger · #12 (**permalink**) 06-10-2008, 02:34 PM

kgm0612:

My insurance carrier is Mercy Health Plans. I don't remember if we are on an HMO or PPO right now. I know we were on an HMO plan last year, but they were talking about switching this year.

Mercy Health Plans - Innovative health insurance options for groups, individuals, and seniors

Regards,

D

lelggren · #13 (**permalink**) 06-10-2008, 05:36 PM

What is the percentage that you usually pay on your DME (supplies like test strips and syringes and things like that. your pump supplies will also fall under that category). If you pay 80% on those, then your copay on the pump will also be 80%. That kindof seems to be the most common percentage for the DME benefit. And if your percentage is 80%, then your copay for the pump won't be any more than $1200-$1300. Also, ask that minimed rep about financing options and things like that.

Also, I must caution you, be very careful of Minimed. They scammed me out of a lot of money on their own errors and stupidity, and then left me to find it later when I got an extra bill in the mail for another about $1200, which was hard enough since I didn't have insurance at the time. Then, when I brought it to their attention, they tried to deny it all and say that there was no error on their part...... So, before you sign anything or order anything, require from them all the documentation of anything they are doing on your account. You might also look into other pump companies too. Minimed pumps don't offer a lot of the same features as cozmo and animas.

Hope you can get on a pump! Really, it changes your whole mindset on your control

Good Luck!

lelggren · #14 (**permalink**) 06-10-2008, 05:51 PM

And I just saw Dewey's sticky on the bashing of pump companies. Sorry if I was bashing, and know that I meant no disrespect to anyone here or their opinions. It was just my experience with minimed. Sorry once again

Thanks

wastcougr · #15 (**permalink**) 06-23-2008, 05:48 PM

I work for the State of Washington and we have a medical expense fund that we sign up for each open enrollment period. I knew I was going to get the pump this year, and I knew that my insurance would cover it at 80%. So, I figured out what that would be, roughly, and then signed up for that amount to be deposited into my flexible spending account. The beauty of that is that I had all $1200 available to me as of January 1st, even though that money is taken out of my paycheck twice per month ($50 each paycheck). So, it's like a payment plan that I pay $100/month on and it's tax-free.

Then, I found out that my stoploss is only $750, but that's OK. I'll have some left over for supplies.

)