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Re: [IP] BCBS MA and CGMS coverage



Bob,

I got the same response last week, they did tell me however that the Dr, 
could file and appeal and it may be consider under special circumstances. 
On another note, I also just found out that BCBS Mass only cover the 
replacement of a pump after 5 years versus the 4 that most other insurance 
companies do.  So unless you buy the extended warranty for a year you walk 
around with a pump out of warranty.

I found this very interesting knowing that my pump warranty runs out on 
April 17th of this year, I got an Omnipod as a replacement but found out 
through my insurance company that they never approved me getting another 
pump and all they did was provide Insulet with the amount I was covered for 
and not for approval for a pump replacement.  Needless to say I sent the 
Omnipod system back due to this and a number of other issues.

John
Dx 1972
----- Original Message ----- 
From: "Bob Scott" <email @ redacted>
To: <email @ redacted>
Sent: Friday, April 04, 2008 4:23 PM
Subject: [IP] BCBS MA and CGMS coverage
>
> I just went through the process of trying to get coverage for the 
> Freestyle
> Navigator CGMS but was rejected. The reason I was told is that BCBS of 
> Mass has
> a restriction in their policies stating that all CGM systems are 
> experimental
> and thus not covered.
>
> Any Massachusetts folks out there with a different experience?
>
> Any advice or insights from people regardless of which state you are in
> regarding if its worth appealing and how to push back on the insurance 
> company
> to get coverage?
>
> I appreciate any help,
>
> Bob
>
> Bob Scott
> .
.
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