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Re: [IP] Arrrrgh, again!!

On 26 Dec 98 at 8:14, Natalie A. Sera wrote:

> Well, Lord Snafu has taken his toll once again:
> Insurance has APPROVED pump and training, BUT they will only pay 50% of
> a $150 lifetime maximum for the training. Oh, and by the way, the
> training totals $3830. 

Who's supplying the training?  I've got a MiniMed and the training cost was 
included in the purchase price.  You don't need the "dry run" with 
saline if you've got a competent trainer, and if you watch the video, read the 
manual, and talk to someone who is actually using the pump for a while your 
training time should be around an hour...  it takes some time to adjust basals 
and ratios, but that's a normal part of changing anything about diabetes 
treatment and shouldn't cost extra unless someone is making a quick 
buck...    You need to find out exactly who's trying to rip you off on this 
training item.  If it's the doctor's office you've probably got problems, but 
if it's a contract trainer somebody has a racket going...  

> How's that for spiritual insurance coverage. They're being SOOOOO nice,
> no?

Nice is generally not a word applied to insurance companies...

> So now I have to figure out how to convince my doc to prescribe the pump
> (which they will cover 80%), and let me go my merry way with it -- I
> have some private resources (otherwise known as friends) who are CDE,
> advanced practice nurses (in Ohio, but it would STILL be TONS cheaper to
> buy a plane ticket to Ohio!) PLUS lots of willing problem-solvers in
> abundance right HERE.
> I ALSO found out that I'm not covered under Nevada's recently passed law
> -- yes, it mandates coverage of diabetes supplies and education, but
> only for commercial companies -- if you're in a "self-funded" plan,
> you're SOL, buddy!

Do you mean private insurance (you pay for it yourself) or some other type of 
> Which is another reason why we need a single-payer system -- our
> patchwork of insurance plans and laws are HIGHLY unfair and unequitable,
> even for those who are ostensibly covered!
> Sorry to rant, but I'm EXTREMELY depressed today. 

Understandable.  Single-payer could possibly improve things, or it could make 
it worse because the "single-payer" might employ bean counters to decide that 
it's cheaper to let people with diabetes, cancer, heart problems.... just die 
and save money on long term treatment...

Unfortunately there's no easy answer.  The only sure thing is that the 
insurance industry wants to raise rates, provide fewer services and also has 
the lobbying power to be guaranteed a healthy profit while disguising it 
through creative accounting...

Randall P. Winchester
* The views expressed here are mine and do not necessarily *
* reflect the official position of anyone in particular.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something. 
Insulin-Pumpers website http://www.insulin-pumpers.org/