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Re: [IP] Medco/test strips FYI



> There is no DME coverage on my policy, but because of Michigan's law 
> regarding diabetes supplies, my supplies are treated like DME but covered.
My self-funded plan is funded by the company my husband used to work for. 
When he was laid off, because his company was bought by a bigger company,
the purchasing company's self-funded plan became our insurance.  So, the
MI law does not apply to them, as they are a MASS company.

However, they do pay for diabetic supplies.  They cover strips and
insulin through the drug portion of the plan (Medco) and pump and CGMS
supplies through the medical part of the plan (Aetna).   The only thing
that is DME would be a new pump or a new CGMS.  The supplies are
considered major medical. 

I purchase my pump supplies from Diabetes Care & Education in Ky, as
they are an in-network provider.  I must get my Navigator sensors from
Apria, as they are the only in-network provider.  After I meet my $850
deductible, then they pay 90% of the cost, up to $1800.  If I hit $1800
then they pay at 100%, as $1800 is my yearly out-of-pocket maximum. 
Drugs, of course, are considered differently and don't go into either
the $850 or the $1800.  You pay the set co-pays for them all year.

We're hoping that the new stimulus plan will help us pay the COBRA
premium for awhile.  Hopefully my DH will be able to find a job sometime
this year.

Judi in MI
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