Comments on: Medicare & pumps

By: Hilton Walter

Hilton Walter — Tue, 23 Aug 2005 23:10:05 +0000

mary,
i think we must have the same employee (diff state maybe ??) adelphia?i
have the pump now
for 8 months.insurance paid all but 250.00 and pay for supplies.i have the
disetronic H tron plus.what state are you in. we are in northern va dc
area.
sharon (interesting who you surf with huh?)i’m curious now.

Hi Mary: Joan Here….there are a lot of things to learn about your
insurance coverage and what your insurance company and Medicare are willing
to cover.
I would suggest that you go to www.cdc.gov and thru that to the diabetes
website links. Medicare has a very complicated set of requirements. It
might be a good idea to contact Insulin Infusion
Specialists…1800-838-7867

and speak to a Customer Service rep. They are the largest supplier in the
US
for all the pumps…Minimed, Disetronic, and Animas.
They can do a precertification; you can get one of the reps to come and
show
you all the pumps so that you can learn the features of each, which one you
think you want to work with…the different insulin administration
sets….they can also help your endo with all the necessary
paperwork…..certificate of necessity and all that, which can take a week
or
so. They can even provide a trainer so that you learn how to handle the
pump
well.
Invest in John Walsh’s book - Pumping Insulin…..it will be an immense
help
in answering a lot of the questions you’ll have.
Don’t be afraid to go back on the pump…If you’re asking us questions,
it’s
because you’ve been following us on the list so you have a pretty good idea
of how we all feel about pumping. Take a shot (no pun intended -
ouch!)….Joan :))))))

By: Olin Ok

Olin Ok — Mon, 22 Aug 2005 16:10:49 +0000

Gail,
Medicare pays for test strips, but you have to jump through hoops to
qualify. I had my endo provide a statement that confirmed that I use
250 strips per month, and as a result, Medicare pays for them. This
becomes a substantial amount on an annual basis. I wish they would do
the same thing for infusion sets.

David

By: colin_140

colin_140 — Mon, 22 Aug 2005 03:51:08 +0000

Hi Mary: Joan Here….there are a lot of things to learn about your
insurance coverage and what your insurance company and Medicare are willing
to cover.
I would suggest that you go to www.cdc.gov and thru that to the diabetes
website links. Medicare has a very complicated set of requirements. It
might be a good idea to contact Insulin Infusion Specialists…1800-838-7867
and speak to a Customer Service rep. They are the largest supplier in the US
for all the pumps…Minimed, Disetronic, and Animas.
They can do a precertification; you can get one of the reps to come and show
you all the pumps so that you can learn the features of each, which one you
think you want to work with…the different insulin administration
sets….they can also help your endo with all the necessary
paperwork…..certificate of necessity and all that, which can take a week or
so. They can even provide a trainer so that you learn how to handle the pump
well.

Invest in John Walsh’s book - Pumping Insulin…..it will be an immense help
in answering a lot of the questions you’ll have.
Don’t be afraid to go back on the pump…If you’re asking us questions, it’s
because you’ve been following us on the list so you have a pretty good idea
of how we all feel about pumping. Take a shot (no pun intended -
ouch!)….Joan :))))))

By: colin_140

colin_140 — Sun, 21 Aug 2005 19:43:27 +0000

Hi Mary

By: Carlos Kiara

Carlos Kiara — Sun, 21 Aug 2005 08:30:24 +0000

Medicare does not pay for supplies does it?
Gail

By: Olin Ok

Olin Ok — Fri, 19 Aug 2005 15:01:44 +0000

Mary,
The rules established by Medicare seem hopelessly bizarre and
unnecessarily restrictive, and probably discourage many potential pump
users from considering the change.

But, I wouldn’t let this stop you from going back on the pump; the
benefits certainly outweigh the hassle implied by this nonsense. It
sounds like that if you qualify for the pump, after you use it for
awhile, you will then lose your qualification, since you will no longer
meet their requirements!

I obtained my pumps (I am on #3 now) from private insurance, but now am
on Medicare. Do you know if they pay for upgrades in any form?

Your averages are similar to mine; I generally have a 30 day moving

average of 130 to 140, and the resulting A1c is 6.9. I test at least
8 times a day, and often more.

David