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[IP] Feedback, PLEASE (insurance approval troubles) !!
I've been lurking and reading, learning a lot from you folks, while waiting
for my insurance to approve a pump for me.
Today I got a call from the Minimed pump rep, saying that my insurance
would grant approval for one month ONLY, or not at all. At that point, I
have to send them the records of my BGs for that period (they already
demanded--and got--my records for a month of pre-pump), and they will pay
for me to keep the pump then only if *they* decide that my BGs have
"improved enough" using the pump to warrant their doing so.
Is this a normal stipulation for an insurance company to make? It sure
doesn't seem reasonable to me.
I have no idea what their criteria are, and I'm afraid they'll just
arbitrarily take the pump away from me after a month.
I called my endo and she said she would contact her pumping rep and see if
he could get my insurance company to agree to an extension, but the person
I spoke to said they had already tried negotiating with the insurance
company, and the company was very adamant that this was the only way I
would be approved.
To say I am bummed is an understatement. I really don't want to start on
the pump (a fairly large and emotion-laden step for me) with no sense that
I (and my doc) have any control over what ultimately happens. I realize
it's possible that pump use might not give me a better handle on my DM, and
I'm willing to take *that* risk, but what if my doctor and I think it's
helping, and the insurance company disagrees?
I am not an unusual candidate for a pump; in fact, I fit the profile of a
candidate who needs, and is likely to be successful with, a pump.
I really need whatever encouragement and advice you are able to offer.
I've been sick for nearly three months now with a cough that just won't go
away, even though I've been to the doctor, followed her instructions and
been through 3 rounds of different antibiotics; and to the chiropractor and
gone through detox. I had a chest x-ray last week and it was clear, but my
chest has been hurting like crazy for the past three weeks (virtually every
step and breath causing it to throb), and it doesn't seem to be getting any
better. I've continued to exercise (mildly) because I know if I don't my
BGs will go wild, but I could make it around the track today at lunch-hour
only through sheer will-power, and at work I'm hanging on by my
fingernails. My morale is really low from fighting this chest thing, and I
don't feel able to fight the insurance company too.
I feel like a wimp and hate to bother everyone, but I'm also a little
desperate. Any advice or thoughts you have to offer will be most
Type 1 for 23 years
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/