[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Coverage for pump education classes-what does it cost?



> >Has anyone gotten their insurance to pay for the pump education classes
> >associated with initially "going on" the pump?  My insurance company as been
> >giving me all sorts of trouble (CIGNA).
> 
> We are having trouble with our insurance over this too, but slightly
> different. Our company (Aetna) says the amount they were charged
> ($500) is more than the usual/reasonable amount for this charge.
> They are refusing to pay 33% of it. This includes the cost for the
> initial start up appointment, the bottle of H, all follow up phone
> calls, one follow up visit with each of the endo, the CDE, and the
> dietician. 

Don't worry yourself about it, just get a written denial, and file an 
appeal. Let them know in plain but polite terms that they can pay the 
bill or you will be happy to sue them for breech of contract -- this 
is not a denial of benefits issue, but a matter of contract law. You 
can probably even take the matter to small claims court if you wish.

> Our CDE says the usual charge is actually about twice
> this much, but they charged us less because we were so prepared and
> did not require as much of her time and effort. She says places like
> Joslin often charge $1200 or more. So, is anyone out there willing
> to share how much was their start up cost, and whether the insurance
> paid it all? Laura
> ---------------------------------------------------------- for HELP
> or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org send
> a DONATION http://www.Insulin-Pumpers.org/donate.shtml
> 
email @ redacted
----------------------------------------------------------
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml