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[IP] An angel at the insurance company

I just thought I would help restore some faith in mankind for any of you
who, like myself, have been lacking lately.  I was told last week that
Medicaid would not make any changes in their authorized infusions sets for
me inspite of the fact that I am allergic to the metal in the ones they will
pay for.  Also, whether the manufacturers recommend 10 sets per month
minimum or not, they would only pay for 7.  I thought it was interesting
that they fight you until you are near death before authorizing a pump to
begin with and then refuse to do what it takes to keep you on it afterwards.
I had done some figuring based on my discussion with them the first of last
week, and I was going to have to come up with over $1000 a year just for
infusion sets and dressings, not to mention alcohol pads and site prep pads,
on top of what they would pay toward my supplies.  This may not seem like
much, but on disability, I receive $6000 a year to live on.  So, it looked
like most of my Pell grants would be going for medical supplies for the next
couple of years.  BUT--ARE YOU READY FOR THIS--I received a note with the
form to request a hearing with a judge on this.  The note said that the
woman who authorizes all of these supplies had called the representative I
had spoken with after she had returned my call.  She asked her to give me
her direct line and have me call today to talk with her about the situation.
When I called her, I explained the problem I had with the metal needles and
what the cost of the Sils that I needed to use.  I also mentioned that the
manufacturers of the pumps recommend a minimum of 10 sets per month.  I told
her that before starting on the pump, I was taken to the hospital at least 3
times a week due to lows and really didn't expect to live much past the
first of the year.  That may sound dramatic, but I am sure some of you
understand just what I mean.  Being unconscious for 12 - 16 hours without
anyone knowing about it is not conducive to a long life.  Anyway, I told her
that I would NOT give up my pump NO MATTER WHAT!!!  I have not even seen a
paramedic in the last month since I started pumping.  She was so surprised
by my reaction to the pump.  My absolute thrill whit it I should say.
Because I am unwilling to go back to MDI and am doing so well with the pump,
she told me that she will do whatever it takes to get my supplies for me.
She is calling tomorrow to let me know what my doctor needs to send to her
for documentation.  She is going to call Disetronic and MM to check into the
pricing and recommendations, etc.  She said that she will make sure I don't
ever have to give up my pump.  She has only had one or two others that she
has authorized that have stayed on their pumps.  I couldn't believe this.
They had said that they were just too time consuming and bothersome.  Boy,
if I had to check my pump every hour and poke my fingers every time I
checked it, I would still rather live than take the "easy" way to treat my
diabetes.  I just thought I would let you all know that sometimes all it
takes is letting the powers that be know just how much we love our pumps to
change their minds about making it so difficult to keep and use them.  I am
certainly glad I did.  I'll let you know what she tells me tomorrow.  I am
so thrilled I just can't stand it.  What a GREAT Christmas present for me!


Oh--I finally decided on a name for my pump--a dear friend can never
remember what it is called, so he always asks about my gadget--so--how about
Inspector Gadget?.

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