[Previous Months][Date Index][Thread Index][Join - Register][Login]
  [Message Prev][Message Next][Thread Prev][Thread Next]

Re: re:[IP] The pumps, my earlier rant, and insurance (long again)

> Our insurance has changed since we got my pump and we now have a 2500
> dollar cap on DME and it is plenty for all the supplies I need every
> year.  It is just going to be a problem when the time comes in the
> future I need  a new pump.
> Talk to the pump people that you go with and see what they say about how
> much that 2500 dollar cap will cover.
> I've never had to pay past that 2500, just my deductible every year and
> the copay.

Thanks for this reassurance, Faith.  I should have responded back when you
sent it.  But because you did, I have done some checking, as best I can
without them knowing the specifics about the particular ins. co. and all of

I'm just wondering what, exactly, are the supplies that you get?  Is it JUST
the infusion sets and reservoirs, or does it include things like IV Prep,
any extra tape you might need, batteries, that kind of thing?

I just got the info they gave me, which included basically the retail price,
which hasn't yet been negotiated with the ins. co., and it looks like just
the infusion sets and reservoirs pretty well wipes it out.

I've been so spoiled.  Prescriptions get so expensive.  My husband just got
a month's worth at the pharmacy for about $98, and that's just our co-pay.
I get just about anything I can think of that I might need through DME
presently.  Blood sugar strips, lancets, Betadine, Skin Prep, extra tape,
etc.  Now I'm going to have to do some stuff completely out of pocket, and
others another pharmacy co-pay every month, and even that is going up.

I keep trying to remind myself that it is a wonderful thing to HAVE the
insurance.  And, provided that my current insurance agrees to the new pump,
I'm even getting that at the right time.  I expect our employer is going to
want a better deal, so surely, when this pump becomes the ancient relic
comparatively speaking that my current one is today, hopefully we won't be
expected to foot the bill.  We are fortunate, in a sense, because my
husband's boss has a lot of sickness in his own family right now, so even if
they didn't care about us, I'd expect they're going to want to get this
changed, the sooner the better, so I'm not going to gripe about it.  Not
yet, anyway.

Thanks again for the encouragement, and for the answer to the question about
how much you get under DME as far as supplies go.  Since all I have is
retail price, and not the ins. negotiated price, I'm basically just trying
to guess at my coverage.  Even this, I know, doesn't mean anything, though,
because everybody's insurance is so different, but I'm thinking I'll get
some picture of what to expect.

I'm already assuming the blood sugar test strips will no longer be DME just
to avoid big bills that we would be stuck with.  The retail price of those
alone would exceed the $2500 cap.

I think I'm rambling.  I'll shut up now.

for HELP or to subscribe/unsubscribe, contact: