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Re: [IP] pump supplies under new insurance??
> My employer just switched to a new insurance policy and I am trying
> to find out if pump supplies is covered. I already have a 508
> model, have been on pump therapy for over 3 years. Our insurance
> coordinator is Beechstreet, which is not an actual insurance
> company, just a coordinator. We have pharmacy benefits through
> Inteq, and medical benefits under Willis. I have never even heard
> of either until now but... I have called both and neither seems to
> know what I'm talking about, much less whether or not it is covered.
> Both said I should call the other. Insulin is covered and so are
> needles and testing supplies. They are mailing me a list of what
> drugs are covered. Neither one knew what durable medical equipment
> is, which is what pump supplies was classified as under my cigna
> policy. What should I do now? How do I find out if it is covered
> or not? Also, if I do indeed find out it isn't covered, is there
> anything I can do? I cannot pay for it out of pocket but shots
> makes me feel sick all the time and my control is horrible without
> the pump. Please give me some advice. I will be needing supplies
> next month and I am very worried. One minute things are covered and
> fine and the next... who knows?
Coverage for diabetes supplies is required by all except two states
for regular insurance companies (not union, gov, or self coverage).
The only states that do not have these laws on the books are Alabama,
North Dakota, Ohio and Idaho.
Generally the laws require that diabetes supplies must be covered.
There is no limitation on what kind of supplies. Check the exact
language of the law in your state at the local library or contact
your state representative's office. The other thing to do is get a
copy of the contract of insurance and read it. That's not as big a
job as you might think and it will answer your question. Absent a
specific exclusion -- one that does not conflict with state law --
your supplies should be covered under either the prescription, home
medical or durable medical sections of the policy.
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