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Re: [IP] RE: Insurance Questions


The following is extracted from a U.S. appeals court decision (Conn.)

>At issue on this appeal is Connecticut's coverage of durable medical equipment
>("DME"). The MAP Manual, the state manual which explains Connecticut's
coverage of >the items listed in its title, defines "Durable Medical Equipment"
as follows:

>"DME" means equipment which meets all of the following requirements:

>a.Can withstand repeated use

>b.Is primarily and customarily used to serve a medical purpose

>    c.Generally is not useful to a person in the absence of an illness or

>d. Excludes items that are disposable.


Sherry Webb Nolan wrote:

> Huh?
> I don't have a denial of supplies.  Mine are paid for 100% under my DME
> coverage.  I don't have a copay for them at all.  I have to pay a copay for
> all my prescriptions.  Why would I want it anyway different?
> I was just stating that most of the people on the list probably get their
> pump supplies paid for under DME.

The comment that I was responding to was that supplies are DME - I think an
insurance company would have a difficult time defending disposable supplies as
being DME.

I personally do not have DME coverage and all my supplies are covered by my
prescription co-payments.

Jim S.

I do not pretend to be an attorney or (at times) even have real knowledge based
on facts
- be prepared when I KNOW that I am "RIGHT" - the most appropriate action is
probably to walk away until I have cooled

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