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[IP] NJ pumpers

To NJ pumpers: Did you know that the same law that requires if you have
prescription service to cover you diabetic supplies also includes
insulin deliver devices with the exception of the pump itself. Your
infusion sets and syringes that go in the pump are both covered by your
prescription plan.

If you are paying more through durable medical goods or not getting
coverage at all, I strongly suggest you look to your prescription
company and their mail order if they have one.

When I first go my pump the state employees used Merck Medco and last
summer we were switched to Advanced PCS. At first Advanced PSC try to
pass off that it should be under durable medical goods and then State
Health Benefits help me show them legally the law shows it is covered
under prescription plans.

Well after I won that battle I checked with Advanced PCS about
availability of Animas cartridge and was told no problem. Three weeks
after mailing in my prescription I have heard every excuse from Advanced
PSC in not filling it. I have my medical now contacting them because
contractually if they can supply the cartridges then I should be able to
order three months supply and get full reimbursement minus $5 copay.

The woman I have been talking to says that many people are unaware that
their pump supplies are covered under the prescription plan and may save
an individual a great deal of money over a course of a year. She has bee
doing research on which other states have similar laws.

This has taken some phone calls and a couple of letter to make sure I
receive the benefits I am entitled to. It's worth it when comparing $5
co pay on cartridge and $5 on infusion sets or 10% of the consumers
price. For it's a savings of $400 a year.

Gail Donohue 
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