[uscrapm]

Hi:

I was wondering who has the best insurance coverage for the pump and supplies? I currently have BCBS PPO and they cover 80% on most items including my pump after deductible. Does anyone have any horror stories related to a specific insurance carrier?

Thanks

[condensr]

I have Premera Blue Cross, and on my particular plan, all supplies and medical care are covered at 100%. No deductibles, no co-pays, nothing.

Its not the carrier though, its more the company. An employer negotiates what benefits their group will get through a particular insurance co, so someone else on BC might not have the same level of coverage that I do.

[jeggeman31]

strips and pumdeductiblesp stuff are paid by my insurance company at 80% after a $200 deductible. My Max out of pocket is $500. Everything (even my $15 co-payments) go toward my max out of pocket. So by late April to Mid May each year I am doing paying for my health care and I pay nothing more out of pocket.


I have United Health Care and pay $50.00 a month for my healthcare.

[JediSkipdogg]

It's really hard to say, because you can't really compare insurance companies anymore. Insurance companies offer so many different plans in their own company that you can be left with good or bad. I use to work for a place that had Anthem and we had to pay 15/30/45 for prescriptions and pump supplies were 100% paid for. But then they upgraded insurance and it changed to 7/15/30 for prescriptions and 20% of all pump supplies. So for the average person, it saved money. For me, it cost me more money since pump supplies more than make up the cost of a few prescriptions.

The ONLY difference between insurance companies anymore is customer service. Some may have slightly different prices on premiums and such, but overall, they are near equal.

[lelggren]

I have Healthwise, through BCBS.

My pump supplies and any other DME are covered at 80%. I have to pay a 40% copay on my insulin and any other formulary brand name rx's, and any preferred generic rx's are $5 (my metformin). Non-Preferred formulary rx's are a 50% copay (my symlin. I hope one day soon that becomes formulary....) Office visits are a $20 copay. I have a $1000 deductable.

It is not the best plan in the world, but my work pays for us to be on it, and also it is soooooo much better than having no insurance at all!!!!

[notme]

I have about the worst coverage out there. My husband pays approximately $400.00 per month for insurance, we have a deductible of $1,500.00, so nothing is paid by insurance until we reach the $1,500.00 then it pays at 85%. After another $1,000.00 Out of Pocket, they pay 100% of everything. It is a Health Savings Account so if we don't use the money that is in the account, then it rolls over to pay expenses next year. I always use it up, but my husband saves his for my use the next year. God help us if he gets sick.

[Funnygrl]

I have community blue in NY. They are good so far. My co-pay for the pump and the first 3 months of supplies is $30. After that, supplies will be covered 100%.

I'm switching to a PPO form of BC/BS in July, and was rushing to get on pump, since I thought my co-pay for a pump went way up. I got the literature on it today, and I was way wrong. All pumps supplies and initial cost is covered 100% through them.

The problem with Community Blue is if you don't use Minimed or Animas, you have to use a 3rd party supplier, which is a bit of a pain in the butt, but insurance approved my pump right away, so that was good.

[poodlebone]

I have an Empire BC/BS HMO plan in New York. They paid for my pump and all supplies 100%, and approved it the day Minimed called them about it. I pay $10 for each diabetic prescription (insulin & strips; in the past it was cartridges & vials and pen needles). I don't need a referral from my PCP in order to see a specialist.

[seacomp]

This thread is somewhat misguided. Each of these companies offer a wide variety of plans with all kinds of options that the individual or employer organization can choose. Most of the differences people are comparing are the differences in the plan chosen by their employee, not in the insurance companies.
Given that, it is useful to see the variations in the coverage that people have both in general and in areas specific to diabetes.

[baby*red]

Originally Posted by jeggeman31

strips and pumdeductiblesp stuff are paid by my insurance company at 80% after a $200 deductible. My Max out of pocket is $500. Everything (even my $15 co-payments) go toward my max out of pocket. So by late April to Mid May each year I am doing paying for my health care and I pay nothing more out of pocket.


I have United Health Care and pay $50.00 a month for my healthcare.

Is this through your work place I assume? I have tricare-they pay 80%. they paid 100% until the policy holder retired. (tricare)

[Cyborg]

On my United plan, my pump co-pay is 100$ and my pump supplies are covered 100%. But... United Healthcare has made several mistakes and tried to charge me much more for the pump and has tried to charge me 100% for my supplies. It has taken me several phone calls to get things finally taken care of and get them to bill correctly. Incompetence comes to mind everytime I work with them...

BTW, my insulin is only 7$/month.

[jeggeman31]

Originally Posted by baby*red

Is this through your work place I assume?

Yes it is, the city I work for is self insured.