Re: [IP] approval for pump by insurance co.
> What general qualifications does one have to get in order to be
> approved for the pump by the insurance company? I realize that each
> insurance company is different, but is it a long drawn out process?
> -Becky - looking to going on the pump
> email @ redacted
The qualifications are the same everywhere in the US
1) a letter of medical necessity from your doctor and
2) a prescription for a pump.
There are some enlightened insurance companies out there that will
provide a pump solely based on the above criteria. However, many of
the insurance companies would like you to think otherwise by asking
for recent hbA1'c, etc... etc....
but... unless the "written contract of insurance" spells out some
requirement of this kind is is spurious bull s--t to help them avoid
paying for coverage they are obligated to provide. It has been my
experience over the years, both personally and through members of the
list, that insurance companies will attempt to divert attention away
from the contract of insurance toward "internal policies", or to draw
you into an argument that has nothing whatever to do with their
obligation to provide coverage that is deemed medically necessary by
your physician and that is covered in the "written contract of
insurance". This is a method of cost control and is done solely to
save them short term dollars at your expense. If I seem a little hard
on the insurance companies you read me correctly. I've spend
countless hours on the phone with these turkeys fighting to get what
I pay for for my family and I'm perfectly willing to pass on what
I've learned including all the tricks they use against us in an
attempt to save a short term buck. The irony is that studies show
that pumpers cost the insurance company HALF of what a non-pumper
costs the insurance company over the long term. You'd think they
would wise up.
So.... if they give you a hard time, speak up. Both here and to them.
We'll all contribute what we know about how to get around their
roadblocks, and you'll get your pump, supplies, or whatever it is
they give you a hard time about.
..... grrrr..... feeling annoyed today....
email @ redacted
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