Recently (as in a month and a half ago) my insurance company, Cigna, approved me for an insulin pump. It was covered 100% and I was told that my pump supplies would also be covered with a co-pay. With my new Animas Ping I got a whole bunch of infusion sets and cartridges. I'm going to be going to a training class next month to learn how to use it - I'm so excited! But I figured I should go ahead and figure out how to order supplies before then.
This past month my company moved to CVS Caremark - I didn't get any information on it besides the new cards and a short list of medications they cover. I went on their website and tried to look up Animas infusion sets/cartridges and saw that it was listed as not being part of my coverage plan.
So I called up Caremark and asked them if they covered pump supplies. The first person I talked to didn't know if it was covered and was going to transfer me to their Diabetes Team, however after 20 minutes on hold I opted to call them back directly. The "direct" line the customer service rep gave me? Right. It actually went to an international adoption agency.
I called back and got a woman who seemed to have no idea what an insulin pump was. When I told her I was trying to find out if they really weren't going to be covering infusion sets she said "Uhhh...what are those? Like ...insulin?". I had to explain to her what it was (details of how it worked exactly, etc) and she decided that those things were considered durable medical supplies and as thus would not be covered by Caremark.
At this point...I'm not sure who to ask. Their customer service staff is not trained on diabetic supplies and obviously cannot give me a straight answer (sorry, a little annoyed at being on the phone for an hour with these people!) and their Diabetic Team may or may not actually exist. That is why I come to you, insulin pumper forum! Have any of you dealt with Caremark? Are infusion sets and the such actually "durable medical supplies"? I'm still not sure on the pump lingo, especially when it comes to insurance companies so any insight for you all would be greatly, greatly, greatly appreciated!
ETA: I just got off the phone with Caremark. It was confirmed that they would not handle durable medical supplies. Cigna then confirmed that they would not be handling DMS, but that another third party vendor - Gentiva - would be handling it for them still. Problem solved!
But feel free to share experiences you've had trying to get prescriptions. Sometimes it helps to vent a little bit.