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[IP] Getting a Pump Update (new pump) denied
Hi. I've been reading all the notes about the denials (especially for kids,
sigh) but not any about getting a second pump. My 506 is 6+ years old. My
endo says that the average life is around 8 years. However, the last time I
saw her, she wanted me to consider the 507c, because of some of the newer
features, ,,,backlight, square-wave and dual-wave. She put the paperwork in
to my HMO, and according to MM, they denied it. I made sure they are aware
that my LCD is broken (though still readable) and the keypad is pretty
cracked. I heard back from the MM rep that my HMO considers these to be
"cosmetic defects". I am currently waiting to hear from my secondary
provider. Things do look promisisng there.
Have you all had much experince with this? I am actually kind of ambivalent
about it because what I think I want is the new animas, waterproof and with
PROFILES, yeah!!! So part of me doesn't care as long as this pump works (and
I can "fake" a dual and square wave). Part of me thinks that I shouldn't let
the HMO get away with it for the sake of others. Part of me is exhausted
with extensive paperwork with two insurance carriers that CANNOT get their
acts together on ANYTHING and each office visit becomes a nightmare to
collect on. And I think the secondary will end up covering it all
anyway...... unless they deny it too. Some things have gone to the State
Insurance comission level.
All in all, I am a fortunate person to already be on the pump and I know it.
I don't mean to be complaining here and I don't want to be greedy, but I had
to laugh at the idea that I wanted a new pump for "cosmetic " reasons (
PUHLEEZE!!!! the LCD has been broken for two years and the cracks before
that!!!) I guess I'm kindof looking for opinions out there along with any
experience with pump "upgrades". By the way, my "ambivalence" on the issue
will die the moment my pump does, and I will regain my fighting tiger stance.
Any postings or personal email to me on this issue would be appreciated..
Thanks....Linda at email @ redacted (mango-home, not man-go-home BTW)
Insulin Pumpers website http://www.insulin-pumpers.org/
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