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RE: [IP] Insurance Regulations



 When you go on Medicare, it will pay 80% of your pump supplies, & insulin &
testing supplies. I have the AARP Supplement J so it picks up the 20% and covers
Medicare deductable. 'J' will also pay 50% of your other RX's . Medicare will
NOT buy a pump, but they will rent it for you and after 14 months it be yours (I
think its 14 months:)
 
 You have to meet Medicare regulations for a pump, there is a list of 'gotta's'
that apply .
You will have to see your doctor every three months to get re supplied.
 Medicare also requires that you be able to prove, (records of readings) for
what ever number of strips you use.
 
don
 
 


jimb <email @ redacted> wrote:
Oh, this is a good one. I realize that this is not about pumping, but I am
certain it needs discussion.

I live in Mass. my wife and I are self employed and pay for our health
insurance.

There is no bridge between my current situation and medicare etc. (5 years
to go) till I'm 65. So I'll have to keep working regardless. 

My concern is what happens when we are on medicare. Whats covered, do I need
a supplemental insurance, will it cover a pump and its supplies????

Most policies, including mine will not allow you to be out of state for more
than 3 months, i.e. read "no coverage" day 91.... puts a dent in the
Snowbird scheme.... unless 3 months is good for you....

Can anyone who is on Medicare or is 65 or both fill in some of the gaps.

I called my HMO and asked them for info about what I can do when I reach 65.

RoseLea, you are very correct in thinking about retirement now....

jimb








At 07:07 PM 1/24/2005, Michael wrote:

>All but 4 states have insurance requirements for covering diabetes 
>supplies. Read your policy cover to cover. If it is not specifically 
>excluded, they are on the hook.
>
>see:
>
>http://www.insulin-pumpers.org/links.shtml#insurance
>
>first two links -- the second shows mandatory coverage by state

I found this to be interesting reading. Clicking on that link and going to
http://www.diabetes.org/advocacy-and-legalresources/state-legislation/health
insurance.jsp
then clicking on the state health insurance link which took me to
http://www.diabetes.org/advocacy-and-legalresources/insurance/overview.jsp I
found that very few states require insurance companies to give anyone with
diabetes an individual policy even at a higher premium. In those instances,
diabetes is considered "uninsurable". The only states that have some type of
state mandated coverage for individual policies were New York, Maine,
Vermont,
Massachusetts, New Jersey, Michigan, Pennsylvania, Rhode Island, Virginia,
North
Carolina and Florida which is required to allow a "self-employed" person to
have
a policy of one and cannot be turned down for coverage because of diabetes.
I
think this is appalling. What do people with diabetes do in the other 39
states?
Make sure they get a job that has health insurance coverage for them after
they
retire, work until they are 65 and are eligible for medicare or just die
when
they can no longer work? Makes us rethink our retirement plans now. We may
have
to keep a legal residence in Michigan regardless of where we actually are
(thinking snowbirds). 

RoseLea
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