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Re: [IP] Re: co pay on pump & pump supplies

Could this be because of the way it actually got billed (not the way whoever
arranged it started it out billing it)?  B/c "durable medical goods" are often
covered 100% vs.  perscriptions which have co-pays.  I've found that strips
often get covered 100% b/c they are not prescription items.  Funy thing though
is that neither is insulin but that usually does have the co-pay.  My
understanding from someone at Aetna was that they often get confused about
what to call pumps and pump supplies so the co-pay can vary dramatically
(0-20%) depending on how it got classified.  She said they are not too
familiar with this kind of medical condition(???).  I keep wondering if we
ought to tell them to get familiar but I'm worried that if we did they would
find a way to make us pay more.


Susan Jordan wrote:

> Jay:
> SAME THING HAPPENED TO ME. It was suppose to pay 25% for my pump, thus I
> set aside the funds.  No bill, I've been pumping for 12 months.  I've
> ordered supplies and do get bills, however, not a one has been  correct
> so I haven't paid for any of my supplies yet.  The first bill they
> didn't get the insurance approval (who in the mean time discontinued
> their serivces, unbenounced to me), it was 800+ for 3 months supplies.
> They told me they were going to try and get it paid when they got the
> new contract w/ my insurance co.  The other time I get a bill for $400
> that says "12 each supplies"...... HUH - I told them if they couldn't
> break it down that I wasn't going to pay it, was that my 25% or what.
> Was that for 3 months, 6 months or 9 montsh.  The bill was total BS and
> I refuse to pay it until they can come clean (by the way I made 6 phone
> calls, all of which I have documented to evidence I tried to work with
> them).
> Susan
> Jay Watson wrote:
> >
> > My experience with the ineptitude of Apria goes the other way.  I was
> > supposed to pay 10% for my pump so I set aside $500 or so to cover the
> > eventual bill.  It has been over 1 year and they have never sent
> > anything.  I order my 3 month supplies through them and I get billed
> > only half of the time.  Perhaps this is why they quadruple the price
> > they charge, when they charge, for the pump.  If that is the case, I
> > want to thank all the other Apria customers for my pump, I really like
> > it!  :)
> > Jay
> >
> > email @ redacted wrote:
> >
> > > Gina, just a little tip about Apria - They DOUBLE at LEAST the cost of
> > >
> > > EVERYTHING before sending it to your insurance company for payment.
> > > My pump
> > > listed at $16,000!!!!!!!!!  That is insane and criminal.  I would have
> > >
> > > returned the pump, and bought the ding dang thing myself on a credit
> > > card and
> > > submitted for reimbursment, but INSURANCE WOULD NOT ALLOW IT!!  Did
> > > anyone
> > > ever wonder why health care is so expensive???  There you go.  Anyone
> > > can buy
> > > this pump from minimed with a prescription for 4500 or so.  I will not
> > > buy
> > > anything from Apria again.
> > >
> > > : )  Food for thought
> > >
> > > Terri