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Re: [IP] insurance (tara)

In a message dated 3/13/99 10:03:42 AM Eastern Standard Time,
email @ redacted writes:

<< However, self-insured business can refuse to cover practically anything
 they don't want to cover, and DM stuff is often not covered because it's
 expensive and the committees making the decisions as to what to cover
 don't really understand why it's necessary.
 So how come I live in a state that DID pass the law, but am working for
 a self-insured entity?????

        We are in the same predicament here.  We live in NY which does have
the Sweeney Law, however our coverage is through my husband's union which
doesn't (or SAYS it doesn't) provide coverage for insulin pumps OR supplies.
We are fighting them tooth and nail to get one for my son who also has severe
asthma and really needs to get a pump.  My doctor had us send a printout from
the hospital showing rates for pediatric ICU and we told them one stay for DKA
will far exceed the price of a pump......we're still waiting to hear on the
appeal, but it is VERY frustrating to live in a state which has this law and
yet be insured by a plan that doesn't have to abide by it.  

	Even if I were to borrow the money from the family and buy the pump, they
STILL refuse to cover supplies so we're really stuck!  It's a shame that they
can get away with this and yet they STILL have NOT given me anything in
writing which states that insulin pumps are not covered.  I've made several
requests so far and they keep giving me reasons for not having it in the
booklet yet and yadda yadda yadda!!  I'll let you know how our next appeal
goes as soon as I hear anything....

Kelly M.

Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org