Insulin Pump Users

I finally got through to Minimed (Molly Gordon) and I learned the following:

1. If one is already on a pump, and it works, then Medicare will not pay for
any upgrade, regardless of the model.

2. Medicare has an arrangement with Minimed so that Minimed supplies a
refurbished 508 on a lease basis. This arrangement does not allow for any
future upgrade.

3. Medicare does pay for supplies, and gives a 3 month supply initially.
Medicare pays 80% of the cost; presumably Medigap will cover the rest.

4. The c-peptide test is under review presently by Medicare; they expect a
revised standard some time soon, whatever that means. The revised limit will
be broader, and include recognition that various labs have different limits set,

and that type II people may still have a need for a pump despite the variying
c-peptide results with thpe II’s. Also, labs use different units for this
test, and that also complicates the results.

So where does this leave me? I am inclined to pay for the upgrade to the 508,
since my warranty expires in November, and then I would be eligible for the
upgrade to the Paradym next year. But, I still have to jump through the
Medicare hoop, and have them deny coverage for the pump; this will allow me to
get the supplies, but no new pump. Since my 507 works just fine, and can be
repaired by Minimed. So, Medicare says ‘denied’.

David

This entry was posted on Monday, December 25th, 2006 at 4:02 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.