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[IP] Re: insulin-pumpers-digest V3 #823

Hi there,

I have been a subscriber to insulin pumpers for a while  now and can't even
begin to put into words how helpful everyone's insight is, and what a
blessing it is.  My boyfriend has been a type 1 for approximately 13 years
now (he is 31) and, as we are planning to be together, I am trying to learn
as much as possible about diabetes, so that in some small way, he won't
have to be "alone" (emotionally).  I have been researching a bunch of
things so that we can get him on the pump.  My question relates to
insurance coverage.  He has Connecticare (formerly Kaiser Permanente,
Farmington, Connecticut).  They barely begin to cover anything (really,
only $100 to $200 of the pump and NOTHING else).  Although I would be
willing to save up and get him on the pump, I have been seeing several
subscribers writing about differences between statutory requirements (what
an insurance company has to cover) and what the insurance company says they
will.  I have tried to get access to Connecticut General Statutues (re:
insurance coverage) but have been pretty unsuccessful.  Is there anyone who
is from Connecticut and knows about state law requirements?  Anything would
be a huge help.  Thanks in advance for your consideration.


insulin-pumpers-digest    Sunday, January 16 2000    Volume 03 : Number 823
Date: Sat, 15 Jan 2000 23:59:34 +0000
From: email @ redacted
Subject: Re: [IP] Re: New Insurance - Pers Choice

I am very happy to hear about this insurance coverage in
CA!  Can anyone help me with the details of the
insurance laws for NJ.  I will be starting my pump this
month and so far have been told by MM that my cost for
supplies will be almost $400/quarter.  Then add on the
usual strips/insulin/etc.....

I am very interested in knowing what the insurance
situation is in NJ.


> At 06:58 AM 01/15/2000 , you wrote:
> >Hoping somebody out there has this insurance, in Calif.  Is new to us -
I am
> >very nervous about pump and D supplies.  Holly
> Gee...I was really hoping you had some information about Pers
> husband also works civil service and is covered under the PERS health
> insurance plans.  We have Kaiser Permanente - Southern Region.  All of
> Anthony's (my 11 year old son) pumping supplies, including his pump was
> covered 100%.  We just got the pump last week, so this is definitely
> the current year coverage.
> My husband will be retiring in another 2 1/2 years at age 55.  We are
> leaving CA....yeah!!!! and PERS Choice and PERS Care will be our only
> out-of-state choices.  You might want to call member services for your
> health plan and ask them if the pump and pump supplies are covered.
> what we finally did with Kaiser when our peds endo only thought they
> pay 50%, and not cover pump supplies at all.  Were we pleasantly
> when we found out that everything was covered.
> >I believe that effective Jan 1, all insurance co.s in CA must pay for
> >diabetes supplies and education. Don't know the specific's of the bill,
> >but it is now in effect.
> I believe this is correct as well.  As of the 1st of January, we no
> pay for test strips, ketostix, or any other testing supplies, including
> lancets and meters.  Previously we paid a prescription co-payment for the
> strips, and ketostix were over the counter...ouch!  Our syringes,
> etc. are still covered under our prescription coverage, but our specific
> plan only has a $5 co-payment for a three month supply.
> Sue
> Torrance CA
> mother of Anthony, 11, dx. 9-22-95...pumping any day now!


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