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Re: [IP] Need Help with Stupid Doctor!!!

In a message dated 5/12/99 4:21:51 PM Eastern Daylight Time, 
email @ redacted writes:

<< There is at least 
 one list member who has experienced this problem, I don't know if 
 the member is still with us. It is the only instance I know of where 
 the denial of benefits was not overturned. >>

		I'm one of the members who had this problem.  My husband's 
union gave us an outright "NO", but after LOTS of letters and pestering it 
was possible to get the pump covered for Steven.  We had to send LOTS of 
proof of how bad things were on MDI and several A1c's, etc.  As many people 
on the list advised us perseverence paid off in the long run.  We ended up 
getting the pump covered at 100% and supplies at 100% too.  They have a 
general clause that they tried to use on us saying that they could exclude 
coverage for items not specifically mentioned in the benefits booklet, but we 
ended up being the first and only ones so far to be approved for the pump.  
They do it on a case by case basis from what I understand.  The one thing we 
learned throught this battle was that the Department of Labor is the 
"governing" or "overseer" of these types of Union Benefits Plans so if you're 
having a problem that is the place to turn for help.  

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