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RE: [IP] Kaiser paying for the pump



Kaiser of Northern CA bought my pump 5 years ago and at the time said it
was the only one they would buy me.  On my 5th anniversary with it, I
talked to them and they bought me a new Minimed 507.  My feeling is that
you just have to know the right thing to say to the right person and you
can get it to happen.  They have also been excellent in paying for my
supplies.  It used to be that you had to have DME (durable medical
coverage) to get these things.  DME is an extra your coverage has to
have.  Group coverage may or may not have it depending on your employer.
I think that individual coverage does not have it.  I know they changed
it so that you could get a meter whether you had DME or not.  However, I
think that you have to have DME in order to get a pump.  If you have
DME, you just need your doctor to send a prescription to the DME
department and they will order if for you.  All pump supplies need a
prescription that you take to the Kaiser pharmacy.  I normally have a
co-pay for prescriptions, but pump (DME) prescriptions are covered 100%.
You mileage may vary depending on your plan.

As for an endo, I would strongly suggest you find one in your location
that has pump experience.  If you are in Northern CA, I or someone else
on this list may be able to give you the name of someone.  My endo has
many people on the pump and I learn things from him and he learns things
from me.  I have a very good relationship with him and he has always
been there when I needed help.  In fact I am going to call him about my
upcoming dental surgery to get his advice from a diabetes and pump point
of view.

Good luck.

- - Jodi

> At 07:41 PM 12/3/97 -0500, you wrote:
> >I was wondering if anyone out there is covered by Kaiser Permanente.
> How are
> >they on pescribing the pump and paying for the supplies?  I have
> decided to
> >"join the club" and get a pump, but I want to know what kind of
> battle I am
> >in for with the insurance company.  I already know that I am going to
> lose my
> >internist because she is too conservative, but I am going to request
> a
> >referral to an endo. You folks have been great and have really helped
> me
> >cleaned up my act  when it comes to regain control. Now I am ready
> for that
> >tighter grip on this disease.  Any comments will be welcome.  
> >~DD
> >email @ redacted
> >
> >