[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]
[IP] Insurance nightmares...sorry, long
Hello everyone, I mostly lurk here, but wanted to share with you what I
have been through this week....and, to possibly get some suggestions on
what I can do to avoid further problems.
I have had several problems over the past few months with my DME, etc.
Thought I had it all resolved the end of Feb when I was able to get the
infusion sets my Dr ordered. (I was having problems with the softsets and
needed to switch) I got my first shipment of Comforts (Chronimed) last
month and they are working much better for me. About a week ago I called
the DME company I have been dealing with for 2yrs to place my order. About
5 days later my test strips came, no infusion sets.....I called and was
told that my insurance company no longer covers pump supplies 8-0.... .I
have to confess I got pretty emotional at that point and demanded to talk
to someone in authority. I explained to this person that I had been through
enough ... (had also gotten a report of elevated protein level, a
hemorrhage in my eye, and a schedule for trigger finger surgery last week)
and I told him I wasn't going to go through this again, I would be calling
a lawyer. He assured me his boss would call me.....
Our insurance is through Ford Mo Co, we have a BC/BS PPO called Blue
Preferred Plus. I decided to call to the place that had finally helped me
last time.....the International Union Benefits Rep Marketing Dept... hey, I
had a name and a number. This person was able to get it resolved within 24
hrs, but I am leary that the battle may be won, not the war!
What I was finally told is that this DME company used to deal with another
company whom had a contract with BC, but now BC is dealing directly with
them. I was told that the DME company has been being told by BC/BS that
they do not cover pump supplies....HELLO!... I have been getting them
covered for two yrs! The owner of the DME explained to me that her company
was going to continue to provide supplies to those of us already getting
them even though they were not going to be reimbursed by BC, as far as they
know. (Hmmm, wonder if it was because she was told about my threat to call
my lawyer?) She explained to me that Medicare doesn't cover pump supplies
and that BC follows whatever Medicare decides.....this blew my
mind!....Medicare, of which I am not eligible yet, makes decisions
regarding my medical care!?.....anyone else heard of this?
Part of my concern is if Medicare doesn't cover this stuff, and it probably
doesn't, what is going to happen to those of us who happen to make it to
Medicare eligility if that is our only insurance?? Do we need to start
educating Medicare about the cost savings??
My supplies are supposed to be in the mail, but I still feel as though I am
in a precarious position.....I am going to start doing whatever I can to
get the most mileage out of each set I get my hands on.....this really
I am calling tomorrow to the benefits rep at Ford to get the *long version*
of our health care package with all the fine print so that I have the
correct info should this war not be over.
Thanks for listening. Would appreciate opinions and any info anyone has
regarding these same type of problems.
email @ redacted
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/