Pumps and Insurance
Never dealt much with insurance other than 'yes, I have it' until now..
The group I will ultimately have insurance with when I graduate says they do not have you undergo medical underwriting and that my diabetes will be covered. What does this actually mean, does anyone know?
I also don't understand PPO other than what it stands for.. are insurances that are PPO better insurances to begin with?
And does that mean more or less likely to cover pumps?
Do you wind up with a ton of waiting periods?
Replies to This Discussion
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Permalink Reply by christy on -
I got my pump right before I switched to my HMO. I had already met my deductible that year with my PPO so I didnt want to wait till the first of the year, but yes my HMO covers pumps and supplies as well.
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Permalink Reply by Jim on -
I went directly to Metronic and had them do all the insurance work. They work with these companies everyday and know who to talk to and what questions need to be asked. I don't think I ever spoke directly with the insurance company. Medtronic then came back and told me what the cost would be for the pump and future supplies.
I suspect if you talk directly to your insurance company your head will hurt once you're done.
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Permalink Reply by palomino on -
You are probably right. My head hurt yesterday just trying to figure out what the heck 'co-insurance' means when talking about pharmaceuticals! I finally figured out the insurance I will be getting is through United Health Care, so I called and asked someone who was very nice.
I have an appt tomorrow with the CDE + one of the doctors I've been seeing at the family physicians group... I may ask them about pumps at that time and then submit a request through Omnipod.
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Permalink Reply by Zoe on -
I agree with Jim; I went directly to Animas and they did all the work for me. Even if it isn't me, somebody was paying them $5,000 for the pump so they are motivated to make it work. I never bothered with the insurance company beyond looking in my book and seeing I had 80% coverage for DME.
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Permalink Reply by palomino on
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When I finally found the policy, it said if you go through Student Health Services they cover 100% of the DME cost. In network preferred providers, 80/20. Out of network was 60/40. But the cap is $2500- which makes me think the omnipod might be possible where the others wouldn't be.
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Permalink Reply by Zoe on
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If your income is low, though, do talk to the pump companies to see if you qualify for a fee waiver (I don't know if you will still be a student or doing some kind of internship before you actually begin your practice).
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Permalink Reply by palomino on
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Yes, let's try... zero for income. :/ But I will give it a shot tomorrow or Tuesday after talking with the doctor- I don't want to give them a surprise.
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Permalink Reply by jrtpup on -
Same here, Animas did it all for me other than some stuff I had to sign for the endo. Same with the Dexcom, I sent logs and they did the rest.
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