I just flipped out at a Medtronic CSR

I know what you're saying. What? But you've always been so satisfied with Medtronic's customer service, Elizabeth! What could they have done to drive you to the point of a total meltdown?

Well, this is what.

In February, I put Eric on MaineCare. Because I do not trust Maine's governor, who seems hell-bent on slashing MaineCare to the bone, I maintained his Anthem policy as well, using what's left of my savings to pay the monthly premium. My thinking was that MaineCare would pay the bits Anthem wouldn't, but Anthem would safeguard Eric if (as I feel quite certain will be the case) our dear governor decides that 3 test strips a day is adequate for children with diabetes. And I duly entered MaineCare into Medtronic's database as his secondary insurance.

A month or so ago, I got a bill for Eric's CGM and pump supplies. Given that we're still in the deductible, I was not surprised to note that Anthem had not covered all the costs, but I was surprised to see that only the Anthem policy was listed on the bill, so I put a note into the envelope saying that they needed to bill MaineCare for Eric's pump supplies and returned it. I then went online and once again updated Eric's insurance info, figuring that somehow, I must not have saved it properly.

Then I get a call from Medtronic today. Speaking with the woman on the phone, I learned that my balance was up to $1600. I was baffled: why had my recent orders not been put through MaineCare? The CSR told me that they did not have the secondary insurance info on his account. How could that be? I had not only entered into CareLink twice, I'd also sent it on the note I'd returned to them a month ago. And, as I told the CSR, I knew that MaineCare covers insulin pump supplies because I'd assured myself that this was the case (although I did not know that they cover CGMs, and that was another reason I was keeping the Anthem policy).

After reading the card info to her on the phone, the CSR said, "Oh, now I see. It's because we're not contracted with MaineCare."

I was puzzled. "What do you mean, you're not contracted with them?"

"We do not have a contract to provide supplies to MaineCare recipients," she explained. "They DO cover pump supplies, but they don't cover them coming from us."

I was horrified. "How can that be? Medtronic is the biggest manufacturer of insulin pumps in the US? Does this mean... I have to put Eric on a different pump?"

"Oh, no," she said. "They pay for pump supplies for our pumps, but from a third-party supplier. I can give you..."

This was all I heard. I had a meltdown at that point.

I have been ordering supplies from Medtronic with MaineCare in place for three months now. NO ONE HAD EVER TOLD ME THAT I COULD NOT ORDER SUPPLIES DIRECT FROM THE MANUFACTURER. No one at DHHS, no one at Medtronic. No one. Moreover, when I checked MaineCare's online coverage info (and believe me, I did check), it said merely that insulin pump supplies were covered. It did not say anything about being covered only through some third party.

And it's not like I hadn't said to either group of bureaucrats that I do not have a regular full-time job and cannot afford to pay out of pocket. I've said so REPEATEDLY.

I don't recall exactly what I said to (screamed at?) the CSR. I do recall that I said, "You mean to tell me I owe $1600 that I cannot afford to pay because NOBODY BOTHERED TO TELL ME THIS??" Which I believe gets the point across. She tried to calm me down. I was in the midst of having a panic attack, complete with hyperventilating, so I simply told her I could no longer discuss the matter with her and we would need to talk about it at some other time. And then I hung up on her.

Much calmer now. Venting helps. But still p***ed.

Views: 569

Tags: insurance, medicaid, pump, supplies

Comment by Snowsue on April 25, 2012 at 5:49pm

That is awful. I had a similar experience but it involved doctor visits. I started going to a Diabetes Nurse Practitioner and loved her. about a year passed and I started getting bills. I called insurance and the doc's office, oh, since the new year started they don't except my insurance anymore. But they did last year, um, yeah, thanks for telling me. They said it was my responsibility to check, whatever. Luckily it was only the cost of 2 doctor's visits, but it took me another year to find another good doctor. Also, with my pump supplies, this year my insurance decided just like you that I had to get my supplies through CCS Medical (a third party supplier) Luckily Medtronic figured that out and informed me and got me to a rep at CCS for my next supply order. Insurance sucks, you have no control over it and it totally controls diabetics, especially with Pumps. Its scandalous.

Comment by Snowsue on April 25, 2012 at 5:50pm

Also remember its not the csr on the other line that's the problem, they are just the messenger. If they really don't get you anywhere, ask to talk to their manager, or ask to talk to an insurance specialist at their company.

Comment by acidrock23 on April 25, 2012 at 7:36pm

?? It sounds like she was going to refer you to the actual culprit who seem to be MaineCare, deciding that they aren't going to cover your convenience? I have the same deal with test strips, I get quite a few more through the BCBS vendor but they suck, are always late, are not able to do anything quickly and well, I don't usually plan 3 weeks ahead to get a refill of stuff?

Comment by Denise Bevard on April 25, 2012 at 9:32pm

my insurance did the snarky third party thing--but Dexcom and Animas both knew and told me, and arranged it all for me..my csr experience with Medtronic was not great (kinda explains why I have a Ping now)

Comment by Elizabeth on April 26, 2012 at 12:41am

I know it wasn't her fault. But she was the person I had at the time, and frankly, I had had the conversation with enough people in the past 4-6 months that SOMEBODY on one end or the other should've spoken up. Honestly, I feel right now that nobody in this country gives a s*** what happens to families dealing with serious medical issues. I am not subject to panic attacks most of the time, but this was a doozy... and now I'm completely unable to sleep now trying to figure out how to pay the bill. Having major swings of anxiety and depression, which is not normal for me. I'm also a little ticked off whenever I think of the way Medtronic starts its robo-call when they want you to pay off your balance — basically threatening you with, "If you don't pay us, no more pump supplies for you!" I'm already aware that my son's well-being is held hostage to the need for pump supplies, thanks. I'm already paying you the money I would RATHER be sending to my mortgage company, THANKS. Don't need to rub it in my face. It's stressful enough being on call for a CWD 24/7 without having a computer-generated bill collector reminding me that I can't afford my son's healthcare.

Comment by Elizabeth on April 26, 2012 at 12:46am

At this point I feel like I'm being held hostage. Your money or your son's life. Only... I don't have any money right now. That could, of course, change tomorrow... I do have prospects for some very good work... but right now, TODAY, I'm pretty miserable because no matter what I do, it just isn't enough.

Comment by suezq1949 on April 26, 2012 at 5:42am

Unfortunately, this will be happening more frequently. Everyone is making cuts in what they will cover. Up until Jan 2012, I had Blue Chip, RI. It was then switched over to Blue Cross Blue Shield New England, Anthem. My $20 copay for 3 months worth of Pods is now $345. I had to fight for my 300 strips which they finally approved, but I will have to go through the process every year.

Comment by Sam Iam on April 26, 2012 at 9:58am

I'm sorry you have to deal with this, Elizabeth. I understand your frustration. I got the Medtronic pump, because my Endo deals with them exclusively. The Medtronic salesman and CDE met with me at my Endo's office.

I've had mostly good, but a couple of bad experiences with CS. It's easy to get angray and paranoid. They are a pretty shady company. But, they do give you what you need. We're stuck with them for a while, so we've got to make the best of it.

Comment by Elizabeth on April 27, 2012 at 5:46pm

I know. And like a miracle from above (or perhaps an act of contrition?), the State of Maine just dropped the answer into my lap. Or perhaps I should say my bank account. My tax refund, in other words, which is sufficient to pay the bill, and which I had completely forgotten was due to me. So I have to call Medtronic in the morning, apologize for my hissy fit, and pay them.

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