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[IP] Insurance woes...
In the three and a half years I have been pumping, I have had nothing but
trouble with insurance companies. In January we (the university where I work)
went to Anthem Blue Cross Blue Shield. I was told in the benefits enrollement
session that my pump supplies would be considered "durable medical" which
carries a $800 annual deductible and then they would pay 70%. I fired off my
appeal letter immediately. My argument was that infusion sets require a
prescription, so they aren't the same as a wheel chair. Also, since they are
disposed of every 2-3 days, they aren't exactly durable either. Basically, I
was told they are considered "durable" because no local in-network pharmacies
will carry them. And my appeal was just denied today.
I called all of the local in-network pharmacies and they say the won't carry
my supplies because they are durable. That's circular logic, isn't it?
My last option is one small paragraph in my plan booklet. It says that durable
medical equipment purchased in a doctor's office is covered under that visit.
I called my endo and asked him if he can buy my supplies and bill the
insurance. He referred me to the supply/purchasing department. They, of
course, gave me a list of pharmacies to call.....who told me that they don't
I'm sooo frustrated. I feel like they are waiting for me to just drop dead so
they won't have to be bothered. Don't they care that my long term health is
better? I will cost them less in the long run if they will just cooperate
now! My last A1C was 6.2 down from the 8's and 9's on MDI.
The university's HR dept. helped me last year to get my supplies covered under
the old insurance company, but this year they aren't responding to me. They
just give me phone numbers at Anthem to call.
To some people, $800 may not be much, but to me it's a fortune. I make less
than $17k after I pay for insurance each year.
How do you guys get your supplies covered? Any tips on what works? I've
written appeal letters, tried to involve HR, called, faxed.... I'm about out
I have a month or two before I need to worry because I stocked up in December
under the last of the old plan, but eventually I will need supplies. The old
credit card will be my last option. I really don't want to go into life long
debt just for my daily needs, though.
>From the massive city of Bowling Green, KY
Who hates insurance folks. They alternate between making her run in circles
and ignoring her existance.
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