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[IP] Re: might not be pumping after all!

"bad news for me folks. checked with insurance today and they said I had to
cover 20% of any pump from any company"

Justin - is this 20% of the actual cost or 20% of the contracted price.
That could be quite a difference.  I have to pay 10% of the contracted price
if it's considered in-network or 30% of the actual cost if the pump is out
of network.  I know that my insurance company has a contract with MM but
have not been able to find out what that price is or if they have a contract
with Deltec for the Cosmo.  For some reason, that I don't understand, they
can't give me that information.

For example for my cataract surgery the actual cost was about $8000 between
the hospital, surgeon, and anesthesiologist.  The contracted cost was about
$3300, so my cost was $330.  Also - do you have a max out of pocket amount?
Mine is $1500 and between the two cataract surgeries, numerous dr.
appointments, etc. I will be pretty well near that by the time I get a new
pump.  At that point everything is covered at 100% so I am trying to get
what ever I need done this year!

When I got my first pump it was covered at 100% but I had already decided
that if they would have paid 0, I would have pulled out the plastic and
gotten it anyway (my Mom had also said she would pay for it).  Four years
later I can tell you it would have been worth the money - what is more
important than your health?  Of course that may not be an option and then
maybe you could check Ebay for used pumps.  Do you have other insurance
options at work?  Maybe you could switch to another plan during the next
enrollment period.

Age 45, Type 1 30 years, pumping 4 years
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