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Re: [IP] Waiting on pump authorization

Hi Eric,

>  I'm know their are plenty of people in this group that had good
>control before they went on the pump.  Did anyone else run into this?

I am in the midst of this right now. I was denied a pump becuase my H1C was
5.8 and that indiciated "that it was not a medical necessity" despite my
endos order and the fact I'm doing MDI as much as 6x day, am technically a
Type II, trying to get pregnant, and have sugars varying *widely* since
going on MDI. My coverage requires I have a 7 or higher A1C. I suppose they
prefer to eventually cover complications than preventing the cost to them by
paying only 5K compared to the 10's of thousands complication and a
uncontrolled diabetic pregnancy will cost them.

I fought back by calling my state representative as I'm on Medicaid (am
waiting to hear back from them) and will appeal my wahzoo off until they
cover a pump. I also got my therapist to recommend the pump and sent that
letter to my endo to help my appeal as my therapist believes (as do I) a
pump may alleviate some of my depression. Even with a great pump-offering
endo, it helps to have another Dr backing up their orders for a pump. You
basically have to find out what your rights are and execrcise, them bad
press coverage is something the insurance companies do not want.

Diestronic has also been helpful by keeping me aware of my options for
renting/purchase and getting a loaner pump. I may even take out a loan
(which I really cannot afford to do as I'm a college student) to purchase a
pump while waiting for the appeal. I just am finding creative ways to
channel my grouchiness about being denied something I *need* to lead a
better quality of life.


                   /\___/\    ((
                  \`@_@'/  ))
Randi "Pixie" Bruner
Moderator Camarilla IRC

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