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RE: [IP] Need Help Working with Pacificare

At 10:28 PM 8/5/02 -0400, you wrote:
 >The plan seems ludicrous - how in G-d's name can the
 >insurance limit Pump & Supplies to $1,500?
.Usually this is a cap on durable medical equipment (DME) which both the 
pump and supplies are classified as.  The limit is not set by the insurance 
company, but by the plan your employer chooses.  Employers can, indeed, set 
a very low cap.  This contains their costs on insurance.  The last place I 
worked had a plan that only covered $1,000 per year of DME.

If you want to go about changing the plan, your best bet is to find as many 
like-minded co-workers as you can and pay a visit to the person in HR who 
deals with health benefits.  If the DME cap is a significant worry to a 
large number of employees it will definitely be worth their while to change 
the benefits plan.

By the way,  DME includes all medically necessary devices, equipment, and 
supplies required for the care of a person outside of a hospital, skilled 
nursing care facility, or other healthcare facility.  Some examples include 
orthotics and prosthetics, wheelchairs, crutches, walkers, and the like; 
sphygmomanometers (blood pressure cuffs -- I just love that word so I have 
to use it once in a while); CPAP masks, mattress pads and pillow covers; 
tracheotomy supplies; oxygen tents...  The list goes on and on.

Chances are good that the DME cap is important to quite a few people in 
your workplace.

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