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Re: [IP] HMO's for diabetic children

> I also would not recommend HMO's for anyone with special health problems.  
> However, I am forced to be on an HMO because that is all that is offered 
> through my husbands work and mine too when I was working.
I am in this exact situation and both my son and I are diabetic.  I also have to say that we were both given pumps with an approval time of 4 days for him and the next day for me.  We were told by MM that our insurance required a log of a month of 4 BS a day, which were sent in with our request for a pump and our letter of medical necessity from our primary care (not endo).  They have paid for our supplies with a 20% co-pay by us, which is what we have on any kind of medical equipment.  We also get 3 months worth of insulin  and our BS strips from the mail order drug place.  We each are allowed enough strips for 12 to 15 tests a day.  So I have to say that the HMO has worked out great for us.

I truly believe that things are very much dependent on your primary care doctor.  I have been with the same Dr for many years and she was in the plan when I went into it.  She has never refused me a consult with any specialist I wanted, including going outside the plan.  She has written the letter for pre-approval outside the plan and permission has been granted every time.  I also take four Rx's that are not in the formulary, but, with preapproval, are paid for through the mail order drugs.

I would not hesitate to recommend my HMO to anyone in the metro Detroit area.  They have been good to me (at least for the past three years that I've been in the plan)

Judi in MI
Jath622 <mail.earthlink.net>
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