Re: [IP] New Pump and Insurance
Ask your HR department for the contact phone numbers for each of the
plans, then call them to find out what the coverage for DME,
particularly insulin pumps, is. Be sure to mention that it is an
insulin pump, because they sometimes have different rules regarding
"diabetes" DME/supplies. I would think that your out of pocket with an
HMO would be less, but it would be harder to get them to cover (approve)
it. Whereas, the PPO might not need to authorize it, but may pay only
80%. (Some pump companies will accept this as payment in full, or at
least the used to.) If you have any problems, call your State insurance
board. Your company is required to provide information necessary to
choose a plan. Is this going to be COBRA?
Antonio in LA, Type 1 since 1993
MiniMed Paradigm 522 RT CGMS
OneTouch Ultra, MiniMed Carelink and PAL software
email @ redacted wrote:
> We are currently trying to get our son a new pump, 17 yrs old dx @8 pumping
8.
> The insurance we can select from is thru Sears/Kmart and is Keystone East
HMO,
> Amerihealth Hmo and Empire Blue Select PPO. Please keep in mind it is not
open
> enrollment time for these plans, it is due to loss of employment. I can not
get
> any information from the insurance companies, human resources dept at
> Sears/Kmart or website for the insurance companies from within the
Sears/Kmart
> doman on DME( Durable Medical Equiptment). HR says I must join the plan to
get
> that information. The pump company can not give me information because I can
not
> give them the member id.
>
> Is there anyone out there with either of these plans, or similar that might
be
> able to shed some light on the DME section of these plans and what may and
may
> not be covered. Concerned about the pump and it's supplies. I am also
thinking
> that strips may not be a DME item any more.
>
> Thank you for your help,
> Karen K
> Bucks County, PA
> email @ redacted
>
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