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RE: [IP] Insurance Coverage Survey

Vernon Catron
www.jacksonville.net/~vcatron <http://www.jacksonville.net/~vcatron>
French Huguenot, Gordonís Musketeers, 1st Regiment of Foot, British Marine,
1st NYV Engineers

-----Original Message-----
From: email @ redacted [mailto:email @ redacted]On Behalf
Of Bridget C. Martin
Sent: Wednesday, February 23, 2000 5:53 PM
To: email @ redacted
Subject: [IP] Insurance Coverage Survey

What Type are you (1, 2, 1.5)?


What was your date of diagnosis?

	June 1995

What was your age of diagnosis?
When did you start pumping?


What was your HbA1c immediately before pumping?

	2/98 14+ 10/99 6.4 with a lot of HYPOS

What was your HbA1c post-pump?

	6.6 1/15/00

Have your HbA1c's continued to improve?

	Yes considering they are not skewed by severe hypos

What is the name of the Insurance Company you were with when you started
the pump?


What form of insurance was/is it (HMO, PPO, etc)?


How long did it take your insurance company to process your claim for the

	1 month

What documents (blood glucose records, medical records, meal logs, etc.),
if any, did you have to submit to your insurance company?

	My Endo and his CDE took care of it all.

How does your insurance company classify the pump (durable medical
equipment, prescription, etc.)?

	DME Requiring a physicians orders and documentation.

Briefly describe the process you went through to get your pump approved by
your insurance company?

	Turned the process over to my Endo and his pump CDE and they did the leg
work, this practice is very pro pump and is very good at knowing just what
is necessary for insurance purposes.

If your insurance company tried to deny approval, did they state a
specific reason?

If you had to appeal a denial of approval, do you know if it went before a
medical review board of some sort?

Have you ever seen a copy of the actual contract that you insurance
company has with your employer (the contract they use in explaining why a
pump would not be covered or in explaining to what extent something will
be covered)?

	Yes, Florida requires diabetic supplies and related items to be covered.

Does your insurance plan cover pump supplies? If you've been on various
insurance plans since pumping, please inform me of what each plan covered.

	My initial plan covered pump supplies and my current carrier does also.

How much is your co-pay for pump supplies?


Does your plan consider pump supplies a prescription, durable medical
equipment or something else?

	Prescription and diabetic supplies

Do you feel your diabetes management has improved because of the pump?

	YES YES YES I got my life back!!!!!

Do you mind if I contact you to ask you further questions about any of
your answers?

	email @ redacted

Please feel free to provide any other information you feel would be

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for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml