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Re: [IP] Two Pumps vs. One Pump Disetronic
Not sure what you are asking here or how we can help, but
I also got one pump.. and I think my insurance company did it illegally
which kind of burns
me a little.. After getting the disetronic it is such a finely made machine
I almost see no need for two pumps but I figure you might as well get what
ya can get.. Am I right?
Apparently if you're on a HMO with my distributor you get one pump.. if
you're on a PPO you get two.. and I was on a PPO when I got the pump unless
they switched me without my knowledge. So I have to do some investigative
work to find out, especially since I no longer have that insurance vendor..
Ronald Kapo wrote:
> In the middle of 12-97 I purchased a Disetronic pump. The Mini-med rep
> for my endo was too over-powering, dictatorial, and self-aggrandizing.
> I purchased the pump outright, having the now obviously ridiculous
> notion that I wanted to be myself responsible for all facets of this
> wonderful piece of technology and believing that we all should assume
> responsibility for our own care. How naive I am!
> I initiated contact with above insurance company before purchase of said
> pump, calling twice to make certain I, as well as they, understood all
> the parameters of my coverage. Two more calls were made to ascertain
> that I was providing the correct and adequate documentation.
> On 1-22-98 my husband mailed the claim (our insurance is his employee
> benefit). First the claim in its entireity was denied - including the
> bills from my endo - all two of them (I have been IDDM for 32 years!).
> A series of communications - absolutely ludicrous in their content -
> ensued. Prudential has now paid for one pump - $2400, completely
> ignoring documentation stating that Disetronic only sells pumps in
> pairs. It was only after one of my students leaped to the same
> conclusion that I have been expecting Prudential to eventually reach
> (not, however, via a leap), and this after a 60 second diatribe from me,
> that I opted to bring this to you.
> Now, Prudential "needs" a statement from my endo attesting to my need
> for two pumps! I have by the way gleaned the info that mine is to be a
> test case, Prudential vs D re two pumps.
> HELP! I still love my pump; love more so the person I am with the pump.
> I am very impressed with all of your technical abilities that I am
> certain I will "net" many strategies from this communication.
> I am very grateful for your willingness to share your experiences on the
> net. I am sure there are many of us who silently read, learn, and
> empathize with those of you courageous enough to speak out so
> Ruth Kapo
> Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/