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Re: [IP] Insurance denial/my right

....44 states require insurance companies to pay for diabetes supplies, all
except Alabama, Idaho, Montana, North Dakota, Ohio, Oregon....

However, in the state of Connecticut, if your employer is self-insured (also
called self-funded), they do not have to cover much.  If the employer
purchases their insurance from an insurance company, there is no cap on
diabetes supply costs.  My employer (a hospital) is self-insured, and was
only going to pay for $300/year for pump supplies (under "medical
supplies").  My husband's employer (also a hospital), is not self-insured,
and with our HMO coverage thru them they are covered at 100% with NO CAP
(under "durable medical equipment").  Under my husband's plan, pump supplies
are considered DME, and there would normally be a $1500 cap per year but
because of our state law, there is no cap for diabetes supplies.  However,
once we reach the $1500 per year, if my son needed some other type of
equipment covered under DME, we would have to pay for it.  It's very

All I know is, that I am grateful for the coverage we have...the HMO also
pays for blood testing strips at 100% (and they've never questioned the
brand or amount), and we receive 3 months supply of insulin at a time for
only a $30 co pay.

The interesting thing is - my hospital and my husband's hospital both have
the same insurance company.  See what a difference policy variations can
make?  My employer has a self-funded PPO plan and my husband's has a
purchased HMO product, both from MedSpan.

Mom of Steven, almost 16, and a very happy pumper since July 7, 1999
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