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I have dealt with a lot of ins. co’s. over the past 49 years since T-1 dx. I
believe it is usual and customary for certain deductions until your plan reaches
the out-of-pocket expenses each year. My costs in 1998 were $25,000. PTL for the
ins. we had. We had $250 deductible plus $2000 OPE, plus $25.00 per week. Ins.
co. changed 7/1 and is giving me fits. The first problem was with the employer
himself!! (teehee).
I would recommend that if that amount completes the OPE for 1999, then crop
everything you can into 1999 to delay OPE in 2000 (surgery, labs, ofc. visits,
meds, etc.). That will give you a breather before immediate money going again.
Jan
Has anyone had any problem with insurance reimbersment for Mini Med pumps?
My husband just received his MiniMed 508 and the company informed us our
insurance only covers a portion of the cost? (a small portion as it turns out).
Since we are so new at this game we are curious about others experience.
Hi Jill:
You should get your physician involved….a lot has to do with semantics
and just what a letter of medical need should include. A pump is considered
durable medical equipment and as such, you should find out the extent that
your insurance will cover.
There are times, if you MD is very good, he/she can state that providing the
pump with allow for better glucose control, he can mention the DCCT study and
the UKPDS study as far as tight control and the reduction of complications
related to diabetes. He can also mention the cost of one hospital admission
for complications related to poorly controlled diabetes…usually that’s the
clincher…depending upon where you live, you ought to call your local
hospital and find out what the cost for just the bed is per day, add another
50-100 % for diagnostic tests and special procedures like CAT scans and MRIs
and it can be very convincing when he shows that providing the pump and
supplies is cost effective and saves money for the company.
There is also no reason why you can’t challenge the company’s decision…you
should touch base with a Diabetes Consumers group in your area…we get
change implemented by not being so accepting….give it a try! Joan
My husband just received his MiniMed 508 and the company informed us our
insurance only covers a portion of the cost? (a small portion as it turns out).
——————
When I got my 507c last March MiniMed checked the insurance company first to
inform me of my O-P-E. Did they not do that for you? Are you stuck now with
exhorbitant costs? I’ve had 2 pumps from MM and they always checked for me
first.
Jan (T-1 49 years, pumping 16 years)
I think CYB (count your blessings). Ins. paying 80% is VERY GOOD. The
suggestions I gave previously should help minimize your other OPEs for 1999.
When I got my first pump 16 years ago the ins. co. deliberated 6 wks. before
okaying — I was their first. They would buy no batteries, tubing, reservoirs,
nor surgical tape. A supply came packaged with the pump — by the time I needed
more the employer changed ins. co’s and we sent in the receipts and there was no
question after that. Diabetes is an expensive disease to choose (gulp!!) but it
is something we have to handle. The ins. co. we got as of 7/1/99 requires us to
pay much more OPEs and we must use their facilities or pay 30% for our own
choosing.
BTW, if your insurance does reimburse you more on the pump MAKE sure MiniMed
sends YOU the money and not keep it as a *credit* on your account.
Jan
If anyone is interested in seeing the specification sheets on the 508 Please
E-mail direct and I will send them to you. I scanned them as jpeg files and
there are 5 sheets equaling about 300 k.
Keep in mind they are the manufacture information that they sent to me.
Frank
Ps. If anyone has the information on how they obtained there pump in Australia
please pass it on. thanks
—– Original Message —–
From: Frank
To: Insulin Pump Users
Sent: Thursday, January 13, 2000 8:30 AM
Subject: [Insulinpumpusers] Minimed 508
If anyone is interested in seeing the specification sheets on the 508 Please
E-mail direct and I will send them to you. I scanned them as jpeg files and
there are 5 sheets equaling about 300 k.
July 1st, 2003 at 1:59 pm
I have dealt with a lot of ins. co’s. over the past 49 years since T-1 dx. I
believe it is usual and customary for certain deductions until your plan reaches
the out-of-pocket expenses each year. My costs in 1998 were $25,000. PTL for the
ins. we had. We had $250 deductible plus $2000 OPE, plus $25.00 per week. Ins.
co. changed 7/1 and is giving me fits. The first problem was with the employer
himself!! (teehee).
I would recommend that if that amount completes the OPE for 1999, then crop
everything you can into 1999 to delay OPE in 2000 (surgery, labs, ofc. visits,
meds, etc.). That will give you a breather before immediate money going again.
Jan
Has anyone had any problem with insurance reimbersment for Mini Med pumps?
My husband just received his MiniMed 508 and the company informed us our
insurance only covers a portion of the cost? (a small portion as it turns out).
Since we are so new at this game we are curious about others experience.
July 2nd, 2003 at 10:59 pm
Hi Jill:
You should get your physician involved….a lot has to do with semantics
and just what a letter of medical need should include. A pump is considered
durable medical equipment and as such, you should find out the extent that
your insurance will cover.
There are times, if you MD is very good, he/she can state that providing the
pump with allow for better glucose control, he can mention the DCCT study and
the UKPDS study as far as tight control and the reduction of complications
related to diabetes. He can also mention the cost of one hospital admission
for complications related to poorly controlled diabetes…usually that’s the
clincher…depending upon where you live, you ought to call your local
hospital and find out what the cost for just the bed is per day, add another
50-100 % for diagnostic tests and special procedures like CAT scans and MRIs
and it can be very convincing when he shows that providing the pump and
supplies is cost effective and saves money for the company.
There is also no reason why you can’t challenge the company’s decision…you
should touch base with a Diabetes Consumers group in your area…we get
change implemented by not being so accepting….give it a try! Joan
July 3rd, 2003 at 2:45 pm
My husband just received his MiniMed 508 and the company informed us our
insurance only covers a portion of the cost? (a small portion as it turns out).
——————
When I got my 507c last March MiniMed checked the insurance company first to
inform me of my O-P-E. Did they not do that for you? Are you stuck now with
exhorbitant costs? I’ve had 2 pumps from MM and they always checked for me
first.
Jan (T-1 49 years, pumping 16 years)
July 3rd, 2003 at 6:54 pm
[This message contained attachments]
July 4th, 2003 at 3:08 pm
I think CYB (count your blessings). Ins. paying 80% is VERY GOOD. The
suggestions I gave previously should help minimize your other OPEs for 1999.
When I got my first pump 16 years ago the ins. co. deliberated 6 wks. before
okaying — I was their first. They would buy no batteries, tubing, reservoirs,
nor surgical tape. A supply came packaged with the pump — by the time I needed
more the employer changed ins. co’s and we sent in the receipts and there was no
question after that. Diabetes is an expensive disease to choose (gulp!!) but it
is something we have to handle. The ins. co. we got as of 7/1/99 requires us to
pay much more OPEs and we must use their facilities or pay 30% for our own
choosing.
BTW, if your insurance does reimburse you more on the pump MAKE sure MiniMed
sends YOU the money and not keep it as a *credit* on your account.
Jan
December 13th, 2003 at 1:47 pm
If anyone is interested in seeing the specification sheets on the 508 Please
E-mail direct and I will send them to you. I scanned them as jpeg files and
there are 5 sheets equaling about 300 k.
December 13th, 2003 at 9:55 pm
Keep in mind they are the manufacture information that they sent to me.
Frank
Ps. If anyone has the information on how they obtained there pump in Australia
please pass it on. thanks
—– Original Message —–
From: Frank
To: Insulin Pump Users
Sent: Thursday, January 13, 2000 8:30 AM
Subject: [Insulinpumpusers] Minimed 508
If anyone is interested in seeing the specification sheets on the 508 Please
E-mail direct and I will send them to you. I scanned them as jpeg files and
there are 5 sheets equaling about 300 k.
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