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Re: [IP] Personal Choice/Blue Cross & Pump Approval

On Sat, 28 Nov 1998, trifona wrote:

> I am currently waiting for my above mentioned insurance company to
> approve me for the pump.  Although I am a prime candidate for pump
> therapy based on a number of reasons, my Rep. tells me that simply
> because my last A1C was 5.6 and thus below their 7.0 threshold, i will
> most certainly be automatically denied on the first go round and thus
> will have to appeal the initial decision.
> In order to prevent that scenario from happening and thus delay my pump
> treatment i wrote a VERY descriptive letter filled with consequences

Consider pointing out to them that your policy does 'NOT" exclude or 
probably even mention pumps, and that it is considered regular or routine 
therapy. You might also ask if you have a leg amputated, are they going 
to make you use a wooden peg just because it works instead of accepted 
'newer' technology like a plastic and metal prothesis. Then you might 
mention that your attorney will have a field day with the comparison.

BTW all the DCCT stats are on the LINKS page of the web site.

Michael -- who really dislikes insurance companies.
Insulin-Pumpers website http://www.insulin-pumpers.org/