[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

[IP] Re: Advocating for yourself

In a message dated 12/28/00 5:54:32 PM Eastern Standard Time, 
email @ redacted writes:

<< From: Terri Brown <email @ redacted>
 Subject: [IP] Help with a Georgia Medicad problem
 I just got some disturbing news today.  Medicaid hasn't paid for any of
 my pump supplies for the last 10 months.  This is the first that I have
 heard about this problem.  Now I am having problems getting my supplies
 for this month.  They also told me that I would have to pay for the past
 10 months of supplies.  Is there anything or anyone I can appeal to?  I
 have been on an insulin pump for 25 months and it upsets me to think
 that I might have to go back to shots.  I appreciate any information
 anyone can give me.  Thanks. >>

Terri - I haven't had experience as a consumer of Medicaid but I have had to 
advocate for others on Medicaid.  You're dealing with a huge, bureaucratic 
organization - one with good people and good ideals but unwieldy in its size 
and unclarity re who can make decisions for what.  First of all, I'd advise 
your getting your own ducks in a row.  Notify your endo or doctor re the 
problem and have them ready to provide background data re your diabetes, the 
need for the pump, your history on the pump, and your current status 
(positives and continuing problems).  Next, you need to document a history of 
Medicaid having paid for pump supplies for the last 10 months.  Demand a 
written (get everything in writing) rationale for their current denial.  
Third, demand in writing, their appeal process including the names of 
supervisory individuals and panels sitting to "hear" your appeal.  Finally, 
call your local state representative and notify them of what's happening (you 
may need their support).  Ask for the rules and regs about Medicaid in your 
state so you'll know what your law is.  Keep us posted.  You have many 
supporters on this listserv.  Mainly, don't back down!  Keep your voice loud 
and clear.  Jill T Peaks Island Maine
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml