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[IP] Insurance denial

Lisa Abrahams writes:
My six year old son Eric was just denied coverage for an insulin pump by
Blue Cross of North Dakota. The denial came after they conveniently lost
the request and had to have everything resubmitted.   The request was
denied because their criteria say you have to be at least 12 years old
and he is too well controlled.  I can only laugh at their reasons.  He
is well controlled because we give him 3-6 injections a day.
I have been told that 2 children under the age of 12 have had pumps
covered by this insurance company.  Does anyone know these kids?  Any
other suggestions?  Thank you,   Lisa, mother of Eric 6, diagnosed Sept.
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Dont know of local details but if your doctor writes that the pump is
medically necessary, they generally have no basis for denial. Of course Eric
isn't going to use the pump but you are going to use it to care for Eric. by
using the pump you are not abrogating any of your childs care but mearly
making it easier to care for him and to take care of his diabetes. ask them
if they would like to do 8 or more injections a day as a child or a pump. It
is harder to use the pump on your child than to do mdi therapy. but you'll
learn and as you do you can teach Eric like all moms teach their diabetic
kids how to do it. I'll bet Eric is doing his own figuring and telling you
what to bolus in just a few years. spot. I'd contact your county medical
society if they continue to refuse the pump.
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